Single dose epidural hydromorphone in labour pain: maternal pharmacokinetics and neonatal exposure.
Introduction: Epidural hydromorphone could be useful in obstetric analgesia as there is a need for a more water-soluble opioid than sufentanil or fentanyl with prolonged analgesic effect. To our knowledge, the pharmacokinetics of epidural hydromorphone has not been evaluated in parturients. Material...
| Publicado en: | European Journal of Clinical Pharmacology Vol. 76; no. 7; pp. 969 - 978 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jul2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143875500&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 143875500 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Jul2020 vid: 76 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 143875500 143875500 143937121 143875500 10.1007/s00228-020-02880-6 143875500 ppf: 969 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Single dose epidural hydromorphone in labour pain: maternal pharmacokinetics and neonatal exposure. aug: au: Puhto, Terhi Kokki, Merja Hakomäki, Henriikka Spalding, Michael Gunnar, Teemu Alahuhta, Seppo Vakkala, Merja affil: Department of Anaesthesiology, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, PO Box 21, 90029, Oulu, Finland sug: subj: Analgesia, Epidural Analgesia, Obstetrical Dihydromorphinone Administration and Dosage Labor Pain Prevention and Control Pain Management Dihydromorphinone Pharmacokinetics Neonatal Assessment Human Pilot Studies Nausea Diagnosis Pruritus Diagnosis Adverse Drug Event Dihydromorphinone Blood Umbilical Veins Analysis Umbilical Arteries Analysis Apgar Score Scales Bupivacaine Administration and Dosage Analgesics, Opioid Adverse Effects Treatment Outcomes ab: Introduction: Epidural hydromorphone could be useful in obstetric analgesia as there is a need for a more water-soluble opioid than sufentanil or fentanyl with prolonged analgesic effect. To our knowledge, the pharmacokinetics of epidural hydromorphone has not been evaluated in parturients. Materials and methods: In this pilot study, seven healthy parturients were given a single epidural dose of hydromorphone for labour pain. One parturient received 1.5 mg, two 0.75 mg and four 0.5 mg of hydromorphone hydrochloride. Dose was decreased due to nausea and pruritus. Hydromorphone's effect, adverse effects and plasma concentrations were evaluated. Neonatal drug exposure was evaluated by umbilical vein and artery opioid concentration at birth. Neonatal outcomes were assessed using Apgar and the Neurologic Adaptive Capacity Score (NACS). Results: All patients received additional levobupivacaine doses on parturients' requests. The first dose was requested at a median of 163 min (range 19–303 min) after hydromorphone administration. A total of 12 opioid related expected adverse events were reported by seven parturients. All newborn outcomes were uneventful. Hydromorphone's distribution and elimination after single epidural dose seem similar to that reported for non-pregnant subjects after intravenous hydromorphone administration, but further research is required to confirm this observation. Conclusions: The optimal dose of hydromorphone in labour pain warrants further evaluation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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