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British Journal of Anaesthesia, Vol 82, Issue 6 929-931, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia

SHORT COMMUNICATIONS

Placental transfer of fentanyl in early human pregnancy and its detection in fetal brain

J. Cooper, E. Jauniaux, B. Gulbis, D. Quick and L. Bromley
Academic Department of Anaesthetics, Middlesex Hospital, Mortimer Street, London W1N 8AA, UK; Academic Department of Obstetrics and Gynaecology, University College London, 86-96 Chenies Mews, London WC1E 6HX, UK; Department of Clinical Chemistry, Academic Hospital Erasme, Universite Libre de Bruxelles, 808 Route de Lennik, B-1070 Brussels, Belgium

We have investigated the transfer of fentanyl across the early human placenta in 38 women (8-14 weeks' gestation) undergoing termination of pregnancy. After administration of a bolus dose of fentanyl 2 micrograms kg-1 at induction of anaesthesia, maternal blood n = 38), placenta (n = 38), amniotic fluid (n = 38) and fetal brain (n = 7) samples were collected and assayed for fentanyl by radioimmunoassay. Fentanyl was detected in all placental and fetal brain samples but not in amniotic fluid. There was a rapid decrease in fentanyl concentrations in maternal serum after the bolus but placental concentrations had not started to decline 30 min later. There was no difference in placental drug concentrations at different gestational ages. These data suggest that there is rapid transfer of fentanyl to the fetus in early pregnancy and that the drug remains in fetal tissue for some time after the initial dose is given to the mother.
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