Bader A M, Fragneto R, Terui K, Arthur G R, Loferski B, Datta S
Department of Anesthesia, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Anesth Analg. 1995 Oct;81(4):829-32. doi: 10.1097/00000539-199510000-00029.
Labor analgesia using continuous epidural infusions of low-dose bupivacaine and fentanyl may be maintained for many hours. We examined the potential for drug accumulation in both mother and neonate after these long-term infusions. Pregnant women receiving a 10-mL/h continuous infusion of labor analgesia with 0.125% bupivacaine and 2 micrograms/mL of fentanyl were evaluated. Maternal venous and umbilical venous drug concentrations were measured at delivery. Umbilical artery blood gases were obtained. Scanlon neurobehavioral testing was performed on all infants. Length of infusion times varied from 1 to 15 h. Maternal and neonatal drug concentrations remained relatively constant throughout the infusion period. All umbilical blood gas values and neurobehavioral scores were within normal limits. In conclusion, even when maintained for many hours, continuous infusion labor analgesia does not appear to result in significant fetal drug accumulation. No adverse neonatal effects were seen.
使用低剂量布比卡因和芬太尼持续硬膜外输注进行分娩镇痛可维持数小时。我们研究了这些长期输注后母亲和新生儿体内药物蓄积的可能性。对接受0.125%布比卡因和2微克/毫升芬太尼以10毫升/小时持续输注进行分娩镇痛的孕妇进行了评估。在分娩时测量母体静脉和脐静脉药物浓度。获取脐动脉血气。对所有婴儿进行斯坎伦神经行为测试。输注时间从1小时到15小时不等。在整个输注期间，母体和新生儿的药物浓度保持相对稳定。所有脐血气值和神经行为评分均在正常范围内。总之，即使持续数小时，持续输注分娩镇痛似乎也不会导致胎儿药物显著蓄积。未观察到对新生儿的不良影响。
