Abstract
Labour is one of the most painful experiences in a woman's life. Epidural analgesia using low-concentration local anaesthetics and lipophilic opioids is the gold standard for pain relief during labour. Pregnancy in general, particularly labour, is associated with changes in maternal haemodynamic variables, such as cardiac output and heart rate, which increase and peak during uterine contractions. Adrenaline is added to labour epidural solutions to enhance efficacy by stimulating the α2-adrenoreceptor. The minimal effective concentration of adrenaline was found to be 2 μg mL-1 for postoperative analgesia. The addition of adrenaline may also produce vasoconstriction, limiting the absorption of fentanyl into the systemic circulation, thereby reducing foetal exposure. However, adrenaline may influence the haemodynamic fluctuations, possibly adding to the strain on the circulatory system. The aim of this study was to compare the haemodynamic changes after application of labour epidural analgesia with or without adrenaline 2 μg mL-1. This was a secondary analysis of a single-centre, randomised double-blind trial. Forty-one nulliparous women in labour requesting epidural analgesia were randomised to receive epidural solution of bupiva...Continue Reading
References
Nov 1, 1978·American Journal of Obstetrics and Gynecology·R P LedermanD S McCann
Apr 1, 1990·Anesthesiology·S C GriceD M Dewan
Dec 1, 1989·American Journal of Obstetrics and Gynecology·E L Capeless, J F Clapp
Nov 7, 1987·British Medical Journal·S C RobsonS Hunter
Aug 1, 1985·Acta Anaesthesiologica Scandinavica·J NeumarkC Biegelmayer
May 1, 1971·British Journal of Anaesthesia·F Reynolds, G Taylor
Sep 1, 1983·American Journal of Obstetrics and Gynecology·S M ShniderG Levinson
Nov 14, 1997·Anesthesiology·M CuratoloA M Zbinden
Oct 17, 1998·Acta Anaesthesiologica Scandinavica·G Niemi, H Breivik
Apr 16, 2003·Acta Anaesthesiologica Scandinavica·G Niemi, H Breivik
Aug 24, 2004·International Journal of Obstetric Anesthesia·S A LeonardG D Shorten
Jun 23, 2006·Anesthesia and Analgesia·Filiep M SoetensMarcel P Vercauteren
Feb 27, 2009·Acta Anaesthesiologica Scandinavica·E Langesaeter
May 14, 2009·Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy·J AkkermansH Wolf
Sep 24, 2010·Anaesthesia·L W J BogertJ J van Lieshout
Aug 30, 2011·European Heart Journal·Vera Regitz-ZagrosekUNKNOWN ESC Committee for Practice Guidelines
Dec 20, 2011·Journal of Hypertension·Guro GrindheimKarin Toska
Feb 14, 2012·Anaesthesia·O BrochB Bein
Mar 15, 2012·Anesthesiology·Jerson R MartinaJohannes J van Lieshout
Jan 30, 2014·Journal of Critical Care·Charlotte HofhuizenJoris Lemson
Sep 4, 2015·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Herbert ValensiseMaria Grazia Frigo
Jan 7, 2016·Conference Proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society·Christian TronstadLeiv A Rosseland
Apr 14, 2017·International Journal of Obstetric Anesthesia·J C KuhnE Langesæter
Oct 20, 2017·Anaesthesia·R Vedagiri SaiP M Jones
Jun 27, 2018·Acta Anaesthesiologica Scandinavica·F HaidlV Dahl