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BJA Advance Access originally published online on December 23, 2005
British Journal of Anaesthesia 2006 96(2):226-230; doi:10.1093/bja/aei311
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

OBSTETRIC ANAESTHESIA

The effects of continuous epidural analgesia on Doppler velocimetry of uterine arteries during different periods of labour analgesia

L. K. Chen1, C. J. Lin1, C. H. Huang1, M. H. Wang3, P. L. Lin1, C. N. Lee2 and W. Z. Sun1,*

1 Department of Anesthesiology and 2 Department of Obstetrics and Gynecology, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan. 3 Department of Anesthesiology, En-Chu-Kong Hospital, Taipei, Taiwan

* Corresponding author. E-mail: wzsun{at}ntu.edu.tw

Background. The transient effects of epidural bupivacaine 0.25–0.5% on the Doppler velocimetry of umbilical and uterine arteries had been reported, but the effects of continuous lower dose epidural bupivacaine (0.05–0.1%) infusion for labour analgesia have never been reported. In this study, we evaluated the effects of continuous epidural bupivacaine 0.075% on the Doppler velocimetry of uterine arteries.

Methods. Twenty pregnant women for labour analgesia received continuous epidural bupivacaine 0.075% infusion. We used a 4-MHz continuous-wave Doppler probe (Multigon 500A) with a 200 Hz thump filter to detect uterine blood flow velocity. We recorded the velocimetry data for uterine relaxation and contraction during five time periods: pre-epidural insertion, 1, 2, and 4 h post-epidural infusion, and after delivery of fetus.

Results. Our data showed that the velocimetric indices of uterine vascular resistance were significantly increased 1, 2, and 4 h after epidural infusion when compared with the pre-epidural level; these returned to the baseline after delivery.

Conclusion. Continuous epidural analgesia with bupivacaine 0.075% increases the resistance of uterine artery and therefore possibly reduces the uterine blood flow.


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CHANGES IN DOPPLER VELOCIMETRY OF UTERINE ARTERIES DURING LABOUR ANALGESIA
FELICITY REYNOLDS, et al.
British Journal of Anaesthesia, 13 Oct 2006 [Full text]
In reply
Wei-Zen Sun, et al.
British Journal of Anaesthesia, 3 Nov 2006 [Full text]

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