title: Effects of narcotic and non-narcotic continuous epidural anesthesia on intrapartum fetal heart rate tracings as measured by computer analysis.
abstract: OBJECTIVE
  To evaluate the effect of narcotic and non-narcotic continuous epidural anesthesia on intrapartum fetal heart rate (FHR) tracings as measured by computer analysis.
  
  
  METHODS
  We studied 37 women with uncomplicated pregnancies at term with reactive FHR tracings. The women were randomized to receive epidural anesthesia with either bupivicaine with fentanyl or bupivicaine alone. One-hour FHR tracings were obtained before epidural anesthesia. Thirty minutes after the initial bolus of the epidural a repeat computer analysis of 60-minute FHR tracing was obtained. Median values are reported for FHR parameters with statistical analysis performed by the Mann-Whitney U and Wilcoxon signed rank tests where appropriate. A power calculation was performed using a power of 90% to determine a required sample size of 28 patients. Statistical significance was set at P < .05.
  
  
  RESULTS
  In early first stage of labor, there was no significant difference in pre- and postepidural anesthesia FHR baseline, accelerations of 10 and 15 beats per minute, episodes of high and low variation, and short- and long-term variation when using either narcotic or non-narcotic anesthetic agents.
  
  
  CONCLUSIONS
  Thus, the clinician can consider the use of narcotic as well as non-narcotic continuous epidural anesthesia in the dosages used in our study with its attendant advantages without fear of obscuring the fetal heart rate tracing.
authors.affiliation: Department of Obstetrics and Gynecology and Reproductive Sciences, UMDNJ-Robert Wood Johnson Medical School, St. Peter's Medical Center, New Brunswick 08901, USA.
authors.forename: C T
authors.initials: CT
authors.lastname: Hoffman
authors.forename: E R
authors.initials: ER
authors.lastname: Guzman
authors.forename: M J
authors.initials: MJ
authors.lastname: Richardson
authors.forename: A
authors.initials: A
authors.lastname: Vintzileos
authors.forename: C
authors.initials: C
authors.lastname: Houlihan
authors.forename: C
authors.initials: C
authors.lastname: Benito
mesh_terms: D000767:Anesthesia, Epidural; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000627:therapeutic use; D036861:Delivery, Obstetric; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D005318:Fetal Heart / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D009294:Narcotics / Q000627:therapeutic use*; D011247:Pregnancy; D011674:Pulse / Q000187:drug effects; D012984:Software
chemical_list: D009294:Narcotics; D005283:Fentanyl; D002045:Bupivacaine