Open Access

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


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Patient demographics. “n” is the number of subjects per group. Values are mean (SD).

Intrathecal fentanyl dose (mcg)
2.551015p-value
(n=135)(n=129)(n=158)(n=131)
Age; years30 (6)31 (6)31(5)30 (5)0.25
BMI; kg.m-232 (7)31 (7)31 (6)31 (6)0.60
Gestational age; weeks38 (4)38 (4)38 (3)38 (2)0.42

Labor and anesthetic variables. Values are mean (95% CI) or number (proportion). “n” is the number of subjects per group. “n” is the same for all rows except for row 2 “VAPS* difference before-CSE† minus after-CSE.”

Intrathecal fentanyl dose (mcg)
2.551015
(n=135)(n=129)(n=158)(n=131)p value
Oxytocin CSE administration prior to47 (35%)37 (29%)52 (33%)56 (43%)0.18
VAPS difference before-CSE5.35.65.36.7
minus after-CSE(4.4–6.1)(4.9–6.4)(4.5–6.1)(6.0–7.4)0.07
n=60n=67n=69n=68
Use of nalbuphine1 (0.7%)4 (3.1%)5 (3.1%)7 (5.3%)0.99
Use of diphenhydramine1 (0.7%)01 (0.6%)00.99
Decrease in MAP‡ > 20% after CSE50 (37%)50 (39%)62 (39%)45 (34%)0.24
Use of phenylephrine3 (2.2%)1 (0.8%)4 (2.5%)3 (2.3%)0.83
Use of ephedrine2 (1.5%)2 (1.6%)8 (5.0%)1 (0.8%)0.12
NRFHRC§6 (4.4%)3 (2.3%)12 (7.6%)4 (3.0%)0.11
Use of nitroglycerine1 (0.7%)02 (1.3%)00.49
Use of terbutaline001 (0.6%)00.61
Emergent minutes after cesarean CSE delivery 30002 (1.3%)00.25
eISSN:
2502-0307
Language:
English
Publication timeframe:
2 times per year
Journal Subjects:
Medicine, Clinical Medicine, other, Surgery, Anaesthesiology, Emergency Medicine and Intensive-Care Medicine