Epidural ropivacaine hydrochloride during labour: protein binding, placental transfer and neonatal outcome.

Hdl Handle:
http://hdl.handle.net/10147/209080
Title:
Epidural ropivacaine hydrochloride during labour: protein binding, placental transfer and neonatal outcome.
Authors:
Porter, J M; Kelleher, N; Flynn, R; Shorten, G D
Affiliation:
Department of Anaesthesia & Intensive Care Medicine, Cork University Hospital,, University College Cork, Ireland. jennyporter@esatclear.ei
Citation:
Anaesthesia. 2001 May;56(5):418-23.
Journal:
Anaesthesia
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209080
PubMed ID:
11350325
Abstract:
This study was undertaken: (i) to quantify the effects of labour and epidural analgesia on plasma alpha1-acid glycoprotein concentration, (ii) to examine the effects of changes in plasma alpha1-acid glycoprotein concentration on plasma protein binding and placental transfer of ropivacaine, and (iii) to examine the association between umbilical venous ropivacaine concentration and neurobehavioural function in the neonate. Multiparous patients undergoing induction of labour received a continuous epidural infusion of 0.1% ropivacaine following an epidural bolus. A significant association was demonstrated between maternal plasma alpha1-acid glycoprotein concentration and 1/free fraction of ropivacaine 60 min after starting ropivacaine administration (r(2) = 0.77) but not at delivery. No significant correlation was demonstrable between maternal unbound ropivacaine concentration and either neonatal (cord) ropivacaine concentration or UV/MV (a measure of placental transfer). Thirty minutes after delivery, 9/10 neonates had neurological and adaptive capacity scores < 35, whereas only three infants had scores < 35 at 2 h. All scores exceeded 35 16 h after delivery. No association between mean (SD) umbilical venous ropivacaine concentration [0.09 (0.08) mg x l(-1)] and neurological and adaptive capacity scores was demonstrated.
Language:
eng
MeSH:
Adult; Amides/administration & dosage/*metabolism; Analgesia, Epidural/*methods; Analgesia, Obstetrical/*methods; Anesthetics, Local/administration & dosage/*metabolism; Apgar Score; Female; Fetal Blood/chemistry; Glycoproteins/metabolism; Humans; Infant, Newborn; Linear Models; Maternal-Fetal Exchange/*physiology; Neurologic Examination; Pregnancy; Prospective Studies; Protein Binding
ISSN:
0003-2409 (Print); 0003-2409 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorPorter, J Men_GB
dc.contributor.authorKelleher, Nen_GB
dc.contributor.authorFlynn, Ren_GB
dc.contributor.authorShorten, G Den_GB
dc.date.accessioned2012-02-03T15:11:44Z-
dc.date.available2012-02-03T15:11:44Z-
dc.date.issued2012-02-03T15:11:44Z-
dc.identifier.citationAnaesthesia. 2001 May;56(5):418-23.en_GB
dc.identifier.issn0003-2409 (Print)en_GB
dc.identifier.issn0003-2409 (Linking)en_GB
dc.identifier.pmid11350325en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209080-
dc.description.abstractThis study was undertaken: (i) to quantify the effects of labour and epidural analgesia on plasma alpha1-acid glycoprotein concentration, (ii) to examine the effects of changes in plasma alpha1-acid glycoprotein concentration on plasma protein binding and placental transfer of ropivacaine, and (iii) to examine the association between umbilical venous ropivacaine concentration and neurobehavioural function in the neonate. Multiparous patients undergoing induction of labour received a continuous epidural infusion of 0.1% ropivacaine following an epidural bolus. A significant association was demonstrated between maternal plasma alpha1-acid glycoprotein concentration and 1/free fraction of ropivacaine 60 min after starting ropivacaine administration (r(2) = 0.77) but not at delivery. No significant correlation was demonstrable between maternal unbound ropivacaine concentration and either neonatal (cord) ropivacaine concentration or UV/MV (a measure of placental transfer). Thirty minutes after delivery, 9/10 neonates had neurological and adaptive capacity scores < 35, whereas only three infants had scores < 35 at 2 h. All scores exceeded 35 16 h after delivery. No association between mean (SD) umbilical venous ropivacaine concentration [0.09 (0.08) mg x l(-1)] and neurological and adaptive capacity scores was demonstrated.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAmides/administration & dosage/*metabolismen_GB
dc.subject.meshAnalgesia, Epidural/*methodsen_GB
dc.subject.meshAnalgesia, Obstetrical/*methodsen_GB
dc.subject.meshAnesthetics, Local/administration & dosage/*metabolismen_GB
dc.subject.meshApgar Scoreen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFetal Blood/chemistryen_GB
dc.subject.meshGlycoproteins/metabolismen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.meshLinear Modelsen_GB
dc.subject.meshMaternal-Fetal Exchange/*physiologyen_GB
dc.subject.meshNeurologic Examinationen_GB
dc.subject.meshPregnancyen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshProtein Bindingen_GB
dc.titleEpidural ropivacaine hydrochloride during labour: protein binding, placental transfer and neonatal outcome.en_GB
dc.contributor.departmentDepartment of Anaesthesia & Intensive Care Medicine, Cork University Hospital,, University College Cork, Ireland. jennyporter@esatclear.eien_GB
dc.identifier.journalAnaesthesiaen_GB
dc.description.provinceMunster-

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