From the Department of Anaesthesia, Intensive Care and Pain, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (EF, BA, YB, CFW).
Eur J Anaesthesiol. 2022 Jan 1;39(1):50-57. doi: 10.1097/EJA.0000000000001514.
Epidural fentanyl doses above 100 μg have been shown, using the paracetamol absorption test, to reduce gastric emptying in fasted labouring women.
To investigate the effect of fentanyl dose on gastric emptying in nonfasted labouring women using gastric ultrasonography.
A double-blinded randomised controlled study.
A tertiary medical centre in Tel Aviv, Israel between 30 July 2020 and 11 October 2020.
Eighty labouring women with cervical dilation 5 cm or less, at least 18 years age, at least 37 weeks gestation with a singleton pregnancy and cephalad foetus.
Women randomised to high (>100 μg) or low (<100 μg) cumulative epidural fentanyl had ultrasound gastric content assessment, measuring antral cross-sectional area (CSA) at epidural placement and 2 h thereafter (T2 h).
The primary outcome was CSA at T2 h comparing high-dose versus low-dose fentanyl. Secondary outcomes included change in CSA between baseline and T2 h. Sub-group analysis compared stomach content at T2 h according to baseline stomach content, empty (CSA <381 mm2) or full (CSA ≥381 mm2), and high-dose versus low-dose fentanyl.
Data from 80 women were analysed; 63 had empty and 17 had full stomach at baseline. There was no significant difference in CSA at T2 h between high-dose, mean 335 ± SD 133 mm2, versus low-dose fentanyl, mean 335 ± SD 172 mm2, P = 0.991. Change in CSA baseline to T2 h was 46 ± SD 149 mm2 for high and 49 ± SD 163 mm2 for low-dose group, P = 0.931. The subgroup analysis according to baseline stomach content showed no statistically significant differences in CSA at T2 h.
The CSA at T2 h was similar for women who received high-dose versus low-dose epidural fentanyl, measured by ultrasound, in our nonfasted labouring cohort.
Clinicaltrials.gov number: NCT04202887.
使用扑热息痛吸收试验，硬膜外芬太尼剂量超过 100μg 已被证明可减少禁食分娩妇女的胃排空。
使用胃超声检查研究非禁食分娩妇女中芬太尼剂量对胃排空的影响。
一项双盲随机对照研究。
以色列特拉维夫的一家三级医疗中心，时间为 2020 年 7 月 30 日至 10 月 11 日。
80 名宫颈扩张 5cm 或以下的分娩妇女，年龄至少 18 岁，至少 37 周妊娠，单胎妊娠，胎头向上。
随机分为高（>100μg）或低（<100μg）累积硬膜外芬太尼剂量组的女性进行超声胃内容物评估，测量硬膜外放置时的胃窦横截面积（CSA）和 2 小时后（T2 h）。
主要结局是 T2 h 时 CSA 比较高剂量与低剂量芬太尼。次要结局包括 CSA 从基线到 T2 h 的变化。亚组分析根据基线胃内容物、空（CSA<381mm2）或满（CSA≥381mm2）比较 T2 h 时的胃内容物，并比较高剂量与低剂量芬太尼。
分析了 80 名女性的数据；63 名女性基线时胃为空，17 名女性胃为满。高剂量芬太尼组 T2 h CSA 为 335±SD 133mm2，低剂量芬太尼组为 335±SD 172mm2，两组间无显著差异，P=0.991。高剂量组 CSA 从基线到 T2 h 的变化为 46±SD 149mm2，低剂量组为 49±SD 163mm2，P=0.931。根据基线胃内容物的亚组分析显示，T2 h CSA 无统计学差异。
在我们的非禁食分娩队列中，使用超声测量，接受高剂量与低剂量硬膜外芬太尼的女性 T2 h CSA 相似。
Clinicaltrials.gov 编号：NCT04202887。
