The influence of epidural blockade and pethidine administered during delivery on neonatal myocardial performance.

The aim of the present study was to investigate whether obstetric analgesia with an epidural blockade (Marcaine, bupivacaine hydrochloride, 141.5 +/- 56.8 mg) and pethidine (95.0 +/- 30.7 mg) influenced neonatal myocardial function following vaginal delivery. Left ventricular output and other left ventricular function indices were measured 5.6 +/- 4.3 h postpartum with Doppler and M-mode echocardiography in a group of healthy, full-term, appropriate-for-gestational-age infants (n = 10) whose mothers had received both bupivacaine and pethidine during delivery, and in a similar group of newborn infants (n = 10) whose mothers had received only nitrous oxide/oxygen analgesia. In 7 of the 10 infants in each groups, a second assessment of myocardial function was performed 21.7 +/- 4.6 h post partum. There were no significant differences in any of the variables used to assess left ventricular function at either of the measurement points between the group of infants whose mothers had received bupivacaine/pethidine during delivery, and the group of infants whose mothers had received nitrous oxide/oxygen analgesia only.