Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 678-682 |
| Number of pages | 5 |
| Journal | British Journal of Anaesthesia |
| Volume | 67 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 1991 |
| Externally published | Yes |
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Keywords
- Anaesthesia, obstetric: Caesarean section.
- Anaesthetic technique: extradural.
- Measurement techniques: Doppler ultrasonics, echocardiography.
- Placenta: blood How velocity.
- Uterus: blood flow, adrenaline.
ASJC Scopus subject areas
- Statistics, Probability and Uncertainty
- Applied Mathematics
- Mathematics(all)
- Statistics and Probability
- Agricultural and Biological Sciences (miscellaneous)
- Anesthesiology and Pain Medicine
Cite this
Effects of extradural bupivacaine with adrenaline for caesarean section on uteroplacental and fetal circulation. / Alahuhta, S.; Rasanen, Juha; Jouppila, R.; Jouppila, P.; Hollmén, A. I.
In: British Journal of Anaesthesia, Vol. 67, No. 6, 12.1991, p. 678-682.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of extradural bupivacaine with adrenaline for caesarean section on uteroplacental and fetal circulation
AU - Alahuhta, S.
AU - Rasanen, Juha
AU - Jouppila, R.
AU - Jouppila, P.
AU - Hollmén, A. I.
PY - 1991/12
Y1 - 1991/12
N2 - 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.
AB - 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.
KW - Anaesthesia, obstetric: Caesarean section.
KW - Anaesthetic technique: extradural.
KW - Measurement techniques: Doppler ultrasonics, echocardiography.
KW - Placenta: blood How velocity.
KW - Uterus: blood flow, adrenaline.
UR - http://www.scopus.com/inward/record.url?scp=0026410450&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026410450&partnerID=8YFLogxK
U2 - 10.1093/bja/67.6.678
DO - 10.1093/bja/67.6.678
M3 - Article
C2 - 1768537
AN - SCOPUS:0026410450
VL - 67
SP - 678
EP - 682
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
SN - 0007-0912
IS - 6
ER -