Canadian Journal of Anesthesia, Vol 39, 277-281, Copyright © 1992 by Canadian Anesthesiologists' Society

ARTICLES

Maternal and fetal effects of intravenous patient-controlled fentanyl analgesia during labour in a thrombocytopenic parturient

OP Rosaeg, JB Kitts, G Koren and LJ Byford
Department of Anaesthesia, Ottawa Civic Hospital, University of Ottawa, Ontario.

The use of intravenous (i.v.) patient-controlled fentanyl analgesia during labour in a parturient with unexplained thrombocytopenia (70 x 10(3).ml-1) is described. The patient self-administered boluses of 25 micrograms of fentanyl with a lock-out interval of ten min. In addition, a concurrent fentanyl infusion of 25 micrograms.hr-1 was given. Effective analgesia was achieved during labour and a total of 1025 micrograms of fentanyl was infused over 11 hr 55 min until delivery of a vigorous infant with Apgar scores of 9 after one and five min. Respiratory depression or undue sedation were not observed in the mother either during labour or in the post-partum period. At birth, maternal total plasma fentanyl concentration was 1.11 ng.ml-1, whereas neonatal umbilical total plasma fentanyl concentration was 0.43 ng.ml-1. Newborn plasma protein binding of fentanyl was lower compared to the mother (63% vs 89%). Thus, free fentanyl concentrations (0.16 ng.ml-1) were identical in the mother and newborn at delivery.

This article has been cited by other articles:

				M. A. Frolich, D. J. Burchfield, T. Y. Euliano, and D. Caton A single dose of fentanyl and midazolam prior to Cesarean section have no adverse neontal effects: [Une seule dose de fentanyl et de midazolam administree avant la cesarienne n'a pas d'effet neonatal] Can J Anesth, January 1, 2006; 53(1): 79 - 85. [Abstract] [Full Text] [PDF]

				C. Castro, U. Tharmaratnam, N. Brockhurst, L. Tureanu, K. Tam, and R. Windrim Patient-controlled analgesia with fentanyl provides effective analgesia for second trimester labour: a randomized controlled study: [L'analgesie auto-controlee avec du fentanyl est efficace pendant le travail obstetrical du second trimestre : une etude randomisee et controlee] Can J Anesth, December 1, 2003; 50(10): 1039 - 1046. [Abstract] [Full Text] [PDF]

				J. A. Thurlow, C. H. Laxton, A. Dick, P. Waterhouse, L. Sherman, and N. W. Goodman Remifentanil by patient-controlled analgesia compared with intramuscular meperidine for pain relief in labour Br. J. Anaesth., March 1, 2002; 88(3): 374 - 378. [Abstract] [Full Text] [PDF]

				F. Roelants, E. De Franceschi, F. Veyckemans, and P. Lavand'homme Patient-controlled intravenous analgesia using remifentanil in the parturient Can J Anesth, February 1, 2001; 48(2): 175 - 178. [Abstract] [Full Text] [PDF]

				A. Laskey and J. Tobias Anesthetic implications of the grey platelet syndrome Can J Anesth, December 1, 2000; 47(12): 1224 - 1229. [Abstract]

				P. K. Morley-Forster, D. W. Reid, and H. Vandeberghe A comparison of patient-controlled analgesia fentanyl and alfentanil for labour analgesia Can J Anesth, February 1, 2000; 47(2): 113 - 119. [Abstract] [Full Text] [PDF]