EFFECTS OF EXTRADURAL BUPIVACAINE WITH ADRENALINE FOR CAESAREAN SECTION ON UTEROPLACENTAL AND FETAL CIRCULATION

We have studied the effects of an extradural block using bupivacaine with adrenaline 90–100 μg on blood flow in the maternal uterine and placental arcuate arteries and the fetal umbilical, renal and middle cerebral arteries, using a colour Doppler technique in eight healthy parturients undergoing el...

Full description

Saved in:
Bibliographic Details
Published in:British journal of anaesthesia : BJA 1991-12, Vol.67 (6), p.678-682
Main Authors: ALAHUHTA, S., RÄSÄNEN, J., JOUPPILA, R., JOUPPILA, P., HOLLMÉN, A.I.
Format: Article
Language:English
Subjects:
adrenaline
Anaesthesia
Anaesthetic technique: extradural
Anesthesia, Epidural
Anesthesia, Obstetrical
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
Blood Flow Velocity - drug effects
Bupivacaine - pharmacology
Cesarean Section
Echocardiography
Epinephrine - pharmacology
Female
Fetus - blood supply
Hemodynamics - drug effects
Humans
Measurement techniques: Doppler ultrasonics
Medical sciences
Neuropharmacology
obstetric: Caesarean section
Pharmacology. Drug treatments
Placenta - blood supply
Placenta: blood How velocity
Pregnancy
Regional Blood Flow - drug effects
Ultrasonography, Prenatal
Uterus - blood supply
Uterus: blood flow
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We have studied the effects of an extradural block using bupivacaine with adrenaline 90–100 μg on blood flow in the maternal uterine and placental arcuate arteries and the fetal umbilical, renal and middle cerebral arteries, using a colour Doppler technique in eight healthy parturients undergoing elective Caesarean section. Fetal myocardial function was investigated simultaneously by M-mode echocardiography. Maternal heart rate increased and diastolic arterial pressure decreased after extradural administration of bupivacaine with adrenaline. The latter effect was relieved by increasing the infusion rate in every case and none of the patients required vaso-pressors. There were no significant differences in maternal or fetal blood velocity waveforms, and no significant changes were found in any of the fetal myocardial measurements relative to control values. These observations suggest that extradural anaesthesia using bupivacaine with adrenaline does not have an adverse effect on vascular resistance in the uteroplacental or fetal circulations or on fetal myocardial function in normal pregnancy when bupivacaine-adrenaline is administered fractionally and maternal hypotension is prevented by rapid crystalloid volume loading.
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/67.6.678