MATERNAL AND NEONATAL FENTANYL AND BUPIVACAINE CONCENTRATIONS AFTER EPIDURAL INFUSION DURING LABOR

Labor analgesia using continuous epidural infusions of low-dose bupiva caine and fentanyl may be maintained for many hours. We examined the p otential for drug accumulation in both mother and neonate after these long-term infusions. Pregnant women receiving a 10-mL/h continuous inf usion of labor analgesia with 0.125% bupivacaine and 2 mu g/mL of fent anyl were evaluated. Maternal venous and umbilical venous drug concent rations were measured at delivery. Umbilical artery blood gases were o btained. Scanlon neurobehavioral testing was performed on all infants. Length of infusion times varied from 1 to 15 h. Maternal and neonatal drug concentrations remained relatively constant throughout the infus ion period. All umbilical blood gas values and neurobehavioral scores were within normal limits. In conclusion, even when maintained for man y hours, continuous infusion labor analgesia does not appear to result in significant fetal drug accumulation. No adverse neonatal effects w ere seen.