Epidural clonidine analgesia in obstetrics: sheep studies.
Epidural clonidine administration produces analgesia by a nonopiate, spinal mechanism, and offers advantages over other epidural agents for labor analgesia. To examine clonidine's acute maternal and fetal effects, the authors injected clonidine, 300 micrograms, epidurally in seven chronically prepared, near term ewes. Unlike epidural saline injection, clonidine increased maternal and fetal serum glucose (by 178 +/- 30% and 190 +/- 30%, respectively; mean +/- SEM, P less than .01) 1 h following injection. Maternal and fetal serum cortisol and arterial blood gas tensions were unchanged following clonidine. Epidural clonidine injection produced minor decreases (10-15%) in heart rate in ewe and fetus, without altering maternal and fetal blood pressure, intra-uterine pressure, or uterine blood flow. Maternal and fetal serum clonidine concentrations peaked at 58 +/- 8 and 73 +/- 5 min following injection, respectively, and declined with similar half-lives. Heart rate correlated negatively with serum clonidine concentration in both ewe and fetus (P less than .05). Apart from hyperglycemia, which does not occur in humans, these results in sheep suggest that epidurally administered clonidine does not adversely affect the fetus and may be evaluated as an analgesic in obstetrics.
Eisenach
J C
JC
Department of Anesthesia, Wake Forest University, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27103.
Castro
M I
MI
Dewan
D M
DM
Rose
J C
JC
D015360:Analgesia, Epidural; D000773:Anesthesia, Obstetrical; D000818:Animals; D003000:Clonidine / Q000008:administration & dosage*; D005260:Female; D005333:Fetus / Q000187:drug effects*; D006339:Heart Rate / Q000187:drug effects; D006340:Heart Rate, Fetal / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006854:Hydrocortisone / Q000097:blood; D007268:Injections, Epidural; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D012039:Regional Blood Flow / Q000187:drug effects; D012756:Sheep; D014599:Uterus / Q000098:blood supply / Q000187:drug effects*
D003000:Clonidine; D006854:Hydrocortisone