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Cardiovascular and endocrine responses to cutaneous electrical stimulation after fentanyl in the ovine fetus

Cardiovascular and endocrine responses to cutaneous electrical stimulation after fentanyl in the ovine fetus
Cardiovascular and endocrine responses to cutaneous electrical stimulation after fentanyl in the ovine fetus
Objective: The purpose of this study was to determine whether physical stimulation is stressful to the ovine fetus, as judged from physiologic changes that are similar to those reported for other stressors (such as hypoxia); whether any stress response could be blocked by clinically used doses of fentanyl; and whether fentanyl alone had any potentially deleterious physiologic effects in the fetus.
Study design: We investigated the effect of fentanyl analgesia on the cardiovascular and endocrine response to cutaneous electrical stimulation in the late gestation (>125 days) ovine fetus (n = 7 fetuses). Chronically implanted catheters and blood flow probes were used to measure fetal arterial blood pressure, heart rate, carotid and femoral blood flow, pH, Po2, Pco2, lactate, cortisol, and ?-endorphin levels before, during, and for 1 hour after 5 minutes of cutaneous electrical stimulation to the lip, forelimb, and abdomen, in a crossover design. Clinically used 30 or 150 ?g doses of fentanyl (which approximated 10 or 50 ?g/kg estimated fetal weight) or saline solution were given intravenously to the fetus 2 minutes before stimulation.
Results: When compared with the control, stimulation caused a significant rise in fetal heart rate (P = .003; mean maximal rise, 48.6±14.0 beats/min, 0-10 minutes after the start of stimulation) but caused no change in any other parameters studied. Neither dose of fentanyl attenuated the changes in heart rate that were observed in response to stimulation alone. Fentanyl alone significantly increased fetal heart rate, carotid blood flow, and lactate and cortisol levels and significantly decreased pH and Po2.
Conclusion: Cutaneous electrical stimulation in the fetal sheep causes an increase in heart rate, which fentanyl does not block. Fentanyl itself has significant effects on the cardiovascular and endocrine system, which might adversely affect the fetus.
sheep, opioid, analgesia, electric stimulation
0002-9378
836-842
Smith, R.P.
c3c9bf74-a063-41b3-8ca1-827eb0abb4ac
Miller, S.L.
18b1f85a-0664-4357-9427-418d61228b31
Igosheva, N.
d31656db-09d4-428d-84a3-38407551ec47
Peebles, D.M.
3f6f6139-3789-456e-8d95-9bb23263b4d6
Glover, V.
3419b76e-c986-4468-9ca6-4091e2edb5b6
Jenkin, G.
37ed29d7-648f-46d5-af31-7881b388ddc5
Hanson, M.A.
1952fad1-abc7-4284-a0bc-a7eb31f70a3f
Fisk, N.M.
32a395c7-ef1a-46c6-9cc8-a6724f309291
Smith, R.P.
c3c9bf74-a063-41b3-8ca1-827eb0abb4ac
Miller, S.L.
18b1f85a-0664-4357-9427-418d61228b31
Igosheva, N.
d31656db-09d4-428d-84a3-38407551ec47
Peebles, D.M.
3f6f6139-3789-456e-8d95-9bb23263b4d6
Glover, V.
3419b76e-c986-4468-9ca6-4091e2edb5b6
Jenkin, G.
37ed29d7-648f-46d5-af31-7881b388ddc5
Hanson, M.A.
1952fad1-abc7-4284-a0bc-a7eb31f70a3f
Fisk, N.M.
32a395c7-ef1a-46c6-9cc8-a6724f309291

Smith, R.P., Miller, S.L., Igosheva, N., Peebles, D.M., Glover, V., Jenkin, G., Hanson, M.A. and Fisk, N.M. (2004) Cardiovascular and endocrine responses to cutaneous electrical stimulation after fentanyl in the ovine fetus. American Journal of Obstetrics and Gynecology, 190 (3), 836-842. (doi:10.1016/j.ajog.2003.09.064).

Record type: Article

Abstract

Objective: The purpose of this study was to determine whether physical stimulation is stressful to the ovine fetus, as judged from physiologic changes that are similar to those reported for other stressors (such as hypoxia); whether any stress response could be blocked by clinically used doses of fentanyl; and whether fentanyl alone had any potentially deleterious physiologic effects in the fetus.
Study design: We investigated the effect of fentanyl analgesia on the cardiovascular and endocrine response to cutaneous electrical stimulation in the late gestation (>125 days) ovine fetus (n = 7 fetuses). Chronically implanted catheters and blood flow probes were used to measure fetal arterial blood pressure, heart rate, carotid and femoral blood flow, pH, Po2, Pco2, lactate, cortisol, and ?-endorphin levels before, during, and for 1 hour after 5 minutes of cutaneous electrical stimulation to the lip, forelimb, and abdomen, in a crossover design. Clinically used 30 or 150 ?g doses of fentanyl (which approximated 10 or 50 ?g/kg estimated fetal weight) or saline solution were given intravenously to the fetus 2 minutes before stimulation.
Results: When compared with the control, stimulation caused a significant rise in fetal heart rate (P = .003; mean maximal rise, 48.6±14.0 beats/min, 0-10 minutes after the start of stimulation) but caused no change in any other parameters studied. Neither dose of fentanyl attenuated the changes in heart rate that were observed in response to stimulation alone. Fentanyl alone significantly increased fetal heart rate, carotid blood flow, and lactate and cortisol levels and significantly decreased pH and Po2.
Conclusion: Cutaneous electrical stimulation in the fetal sheep causes an increase in heart rate, which fentanyl does not block. Fentanyl itself has significant effects on the cardiovascular and endocrine system, which might adversely affect the fetus.

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More information

Published date: 2004
Keywords: sheep, opioid, analgesia, electric stimulation

Identifiers

Local EPrints ID: 25989
URI: http://eprints.soton.ac.uk/id/eprint/25989
ISSN: 0002-9378
PURE UUID: 5c5f3c46-171a-4b5c-b763-45a62268eca6
ORCID for M.A. Hanson: ORCID iD orcid.org/0000-0002-6907-613X

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Date deposited: 12 Apr 2006
Last modified: 16 Mar 2024 03:17

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Contributors

Author: R.P. Smith
Author: S.L. Miller
Author: N. Igosheva
Author: D.M. Peebles
Author: V. Glover
Author: G. Jenkin
Author: M.A. Hanson ORCID iD
Author: N.M. Fisk

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