Method of analgesia for labor in relation to newborn condition, cord blood cortisol and interleukin-6 levels

Abstract

Abstract Aim of the study: To assess the impact of various forms of intrapartum analgesia on birth condition of the newborn. Material: The study included 109 newborns, among them 23 from mothers who received intravenous patientcontrolled analgesia (PCA) using remifentanil (0.2μg/kg per dose), 31 infants from mothers treated with PCA epidural anesthesia with fentanyl and 0.125% bupivacaine, 34 newborns from mothers treated with pethidine analgesia given on an ad hoc basis at a dose of 50mg by intramuscular injection, and 21 newborns from mothers who did not use any form of anesthesia. Methods: The birth condition was evaluated in all infants by Apgar score and umbilical artery blood gases. In the blood from the umbilical vein the concentration of cortisol and interleukin-6 were evaluated. Results and conclusions: The use of epidural analgesia with bupivacaine as well as pethidine given intramuscularly did not impair the status of newborn evaluated on the basis of Apgar score, however, it adversely modifies the pH and umbilical artery blood pCO2. No additional beneficial effect of anesthesia using remifentanil intravenous PCA method on newborn status assessed on the basis of the value of Apgar score and acid-base balance of umbilical artery blood was found and it does not allow to recommend this form of anesthesia as surpassing the existing methods of intrapatum analgesia. The concentration of cortisol and interleukin-6 in umbilical cord blood is not related with the type of maternal intrapartum analgesia.