NEONATAL SIDE EFFECTS DURING PATIENT CONTROLLED INTRAVENOUS REMIFENTANIL FOR LABOR ANALGESIA
Journal
Macedonian Journal of Anaesthesia
Date Issued
2020-04
Author(s)
Ivanov, Emilija
Mehmedovic, Nadica
Abstract
Introduction: Remifentanil is becoming more and more popular as alternative method for
labor analgesia. There are limited studies about the neonatal safety of remifentanil for labor
analgesia.
Materials and Methods: Our study included 80 pregnant women, at term, receiving intravenous PCA with remifentanil for labor analgesia. Our primary goal was to examine neonatal
safety when using remifentanil. During analgesia fetus was monitored through continuous cardiotocography recording. After delivery we recorded neonatal Apgar scores in 1st, 5th and 10th
minute, acid-base status, use of naloxone and any neonatal resuscitation. Parturients all the time
during labor analgesia have one-to-one care and complete haemodynamic monitoring (SaO2,
respiratory rate, non-invasive blood pressure, and heart rate).
Results: Fetal heart rate (FHR) abnormalities were recorded in 12 patients, 4 of them had
pathological continuous cardiotocograph (CTG) records. The most common Apgar score in the
1st minute was 8, in the 5th it was 9 and in the 10th minute it was 10. Intermediate values of all
parameters from the umbilical acid-base status of newborns were within normal limits.
Conclusion: Neonatal side effects during patient-controlled intravenous analgesia with
remifentanil are minimal. One-to-one care, appropriate continuous monitoring of the parturient
and neonate with available resuscitation kit are mandatory
labor analgesia. There are limited studies about the neonatal safety of remifentanil for labor
analgesia.
Materials and Methods: Our study included 80 pregnant women, at term, receiving intravenous PCA with remifentanil for labor analgesia. Our primary goal was to examine neonatal
safety when using remifentanil. During analgesia fetus was monitored through continuous cardiotocography recording. After delivery we recorded neonatal Apgar scores in 1st, 5th and 10th
minute, acid-base status, use of naloxone and any neonatal resuscitation. Parturients all the time
during labor analgesia have one-to-one care and complete haemodynamic monitoring (SaO2,
respiratory rate, non-invasive blood pressure, and heart rate).
Results: Fetal heart rate (FHR) abnormalities were recorded in 12 patients, 4 of them had
pathological continuous cardiotocograph (CTG) records. The most common Apgar score in the
1st minute was 8, in the 5th it was 9 and in the 10th minute it was 10. Intermediate values of all
parameters from the umbilical acid-base status of newborns were within normal limits.
Conclusion: Neonatal side effects during patient-controlled intravenous analgesia with
remifentanil are minimal. One-to-one care, appropriate continuous monitoring of the parturient
and neonate with available resuscitation kit are mandatory
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