Umbilical analgesic concentrations after labour analgesia with programmed intermittent epidural bolus: a prospective observational study
Authors' conclusion
Umbilical analgesic concentrations at delivery were low after labour analgesia using a regimen of PIEB with PCEA for up to 19 hr.
Study context
- Population
- Parturients with singleton pregnancies receiving combined spinal-epidural labour analgesia with programmed intermittent epidural bolus (PIEB) and patient-controlled epidural analgesia (PCEA) (0.08% ropivacaine, 2 μg·mL-1 fentanyl)
- Participants
- 50 participants
- Outcome
- Umbilical venous ropivacaine and fentanyl concentrations
- Follow-up
- At delivery
Main finding
As reported in the abstract
Umbilical venous analgesic concentrations
- Ropivacaine concentration, median [IQR] 77 [56-98] ng·mL-1
- Fentanyl concentration, median [IQR] 0.125 [0.125-0.20] ng·mL-1
- Concentrations correlated with labour duration and total dose
Observational data: associations, not effects.
Further findings
Hourly ropivacaine and fentanyl doses
- Ropivacaine hourly dose, median [IQR] (mg·hr-1)
- 13 [11-15]
- Fentanyl hourly dose, median [IQR] (µg·hr-1)
- 39 [30-50]
Umbilical concentrations with vs without clinician-administered boluses within 1 hr before delivery (subgroup)
- Ropivacaine, clinician-administered boluses within 1 hr before delivery vs without, median [IQR] (ng·mL-1); similar
- 81 [54-104] vs 77 [54-96]
- Fentanyl, clinician-administered boluses within 1 hr before delivery vs without, median [IQR] (ng·mL-1); similar
- 0.20 [0.125-0.20] vs 0.125 [0.05-0.20]
Correlates of umbilical analgesic concentrations
- Umbilical analgesic concentrations correlated with labour duration and total dose
Safety
Neonatal condition at delivery
- Neonates requiring respiratory support
- 14
- Umbilical arterial pH > 7.2 in all neonates
- Apgar score at 5 min ≥ 8 in all neonates
- No neonates exhibited systemic local anesthetic toxicity
Original publication
Umbilical analgesic concentrations after labour analgesia with programmed intermittent epidural bolus: a prospective observational study. Can J Anaesth. Published 10 June 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →