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Database - Alliance francophone pour l'accouchement respecté (AFAR)

Description of this database

Created on : 15 Dec 2003
Modified on : 02 Dec 2007

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Author(s) :

Mattingly JE, D’Alessio J, Ramanathan J.

Bibliographical entry (without author) :

Effects of obstetric analgesics and anesthetics on the neonate : a review.
Paediatr Drugs. 2003;5(9):615-27.

Year of publication :


Résumé (français) :

Abstract (English):

Most anesthetic and analgesic agents in current use traverse the placental barrier in varying degrees, but are well tolerated by the fetus if judiciously administered. For labor analgesia, many options are available. Systemic administration of opioids and sedatives is one such option. Repeated maternal administration of opioids such as pethidine (meperidine) results in significant fetal exposure and neonatal respiratory depression. Patient-controlled analgesia with synthetic opioids such as fentanyl, alfentanil, and the new ultra-short-acting remifentanil may be used for labor analgesia in selected patients.Other options for labor analgesia include epidural and combined spinal-epidural techniques. With such techniques, neonatal exposure to opioids and sedatives can be minimized or totally avoided. While limiting the fetal exposure to the harmful effects of depressant drugs, epidural anesthesia and/or analgesia improves placental perfusion and oxygenation of the fetus, which is beneficial, especially in conditions such as pregnancy-induced hypertension. Regional blocks are also administered for the majority of cesarean deliveries because of the overwhelming and unequivocal evidence of maternal and fetal safety compared with general anesthesia for this indication. However, in some instances, administration of general anesthesia is unavoidable. Neonatal respiratory depression with low Apgar scores, and umbilical arterial and venous pH associated with general anesthesia, is often transient. A properly administered anesthetic, whether regional or general, has no significant adverse fetal or neonatal effects.

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Keywords :

pain medication ; epidural ; maternal age ; pain

Author of this record :

Cécile_Loup — 15 Dec 2003

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