Kumar Manoj, Paes Bosco
Department of Pediatrics, McMaster Children's Hospital at Hamilton Health Sciences, Hamilton, Canada.
J Perinatol. 2003 Jul-Aug;23(5):425-7. doi: 10.1038/sj.jp.7210905.
Epidural opioid analgesia is commonly employed as a therapeutic modality in the management of pain during labor. The general perception among health-care providers is that administered drugs remain in the maternal epidural space and do not compromise the respiratory status of newborns. We describe the clinical course of two newborns who developed respiratory depression following epidural fentanyl analgesia requiring administration of naloxone. The article further reviews the maternal-fetal-placental pharmacokinetics of epidural fentanyl and the possible mechanisms for the causation of neonatal respiratory depression.
硬膜外阿片类药物镇痛常用于分娩期疼痛管理。医护人员普遍认为，给药后药物会留在产妇硬膜外腔，不会影响新生儿的呼吸状态。我们描述了两名新生儿在硬膜外注射芬太尼镇痛后出现呼吸抑制，需使用纳洛酮治疗的临床过程。本文还进一步回顾了硬膜外芬太尼在母胎胎盘的药代动力学以及新生儿呼吸抑制的可能原因。
