Neonatal Respiratory Depression and Intrathecal Fentanyl

  • V.H. González Cárdenas Physician and Surgeon, Anesthesiologist, Clinical Epidemiologist, Anesthesiology and Critical Care Instructor, La Samaritana University Hospital, Clinical Faculty, Universidad de la Sabana; Anesthesiologist, San José University Children's Hospital; FUCS Instructor, Intensivist Anesthesiologist, Colombia University Clinic, Sanitas Organisation; Department of Mother and Child Clinic, Saludcoop Corporation, Bogotá, Colombia
Keywords: Anesthesia, Conduction, Cesarean section, Prevalence, Respiratory insufficiency

Abstract

Objective: To establish the prevalence of neonatal respiratory depression in patients exposed to intrathecal fentanyl during Cesarean section.

MethodsCross-sectional Analytical Observational Retrospective Study conducted at the Mother and Child Clinic of the Saludcoop Corporation in patients undergoing C-section who received intrathecal fentanyl for regional anesthesia in 2007 and 2008. Primary endpoints: low APGAR score (APGAR<7) and severe APGAR (APGAR<4).

Results: 2165 records of C-sections and intrathecal fentanyl with a mean dose of 19.21mcg (SD=0.206mcg). Prevalence of low APGAR at 1.5 and 10 minutes was 1.77% (SD=0.63%), 0.11% (SD 0.163%), and 0%, respectively. The latter two values were different from the 1-minute value (ANOVA Scheffé Test, p=0.031) and there was no difference between them (minutes 5 and 10) (ANOVA p=0.861). Severely diminished APGAR results were, 0.059% (SD 0.058) 1 minute after birth and 0% at 5 and 10 minutes. There were no statistically significant differences between the three severely diminished values (ANOVA p=0.861).

ConclusionsThe prevalence of respiratory depression measured with the APGAR test at birth is low; severely compromised APGAR shows a trend towards 0 in the different minutes of assessment. However, the reliability of the diagnostic tool (APGAR) is questionable, considering discrepancies when the analysis is done with a far more sensitive diagnostic tool (Silverman test).

The importance of this study relates only to the assessment of prevalence and its use as a source of a research hypothesis, and not as an association or prediction study.

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How to Cite
1.
González Cárdenas V. Neonatal Respiratory Depression and Intrathecal Fentanyl. Colomb. J. Anesthesiol. [Internet]. 2012Apr.1 [cited 2022Jan.20];40(2):100-5. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/817

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Published
2012-04-01
How to Cite
1.
González Cárdenas V. Neonatal Respiratory Depression and Intrathecal Fentanyl. Colomb. J. Anesthesiol. [Internet]. 2012Apr.1 [cited 2022Jan.20];40(2):100-5. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/817
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