Lower, Variable Intrathecal Opioid Doses, and the Incidence of Prolonged Fetal Heart Rate Decelerations After Combined Spinal Epidural Analgesia for Labor: A Quality Improvement Analysis.

Journal: Romanian journal of anaesthesia and intensive care
Published Date: Dec 31, 2020

Abstract

BACKGROUND: Combined spinal-epidurals with low-dose intrathecal opioids and local anesthetics are commonly used to initiate labor analgesia due to the fast onset of analgesia and good patient satisfaction. Intrathecal fentanyl has been associated with fetal bradycardia, and the rate may be higher at doses of 25 mcg and above. As such, our institution limits intrathecal fentanyl doses to less than 15 mcg for labor. Prompted by a few incidents of prolonged fetal bradycardia at even these low doses, we sought to audit the side effects associated with varying low doses of intrathecal fentanyl.

Authors

  • Sheena Hembrador
    Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Box 356540, Seattle, WA 98195, USA.
  • Carlos Delgado
    Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Box 356540, Seattle, WA 98195, USA.
  • Emily Dinges
    Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Box 356540, Seattle, WA 98195, USA.
  • Laurent Bollag
    Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific Street, Box 356540, Seattle, WA 98195, USA.

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