The outcome of preterm neonates with intraventricular hemorrhage delivered with intravenous meperidine or epidural analgesia

J Anesth. 2007;21(1):90-3. doi: 10.1007/s00540-006-0461-2. Epub 2007 Jan 30.

Abstract

We aimed to study, retrospectively, the neonatal outcome of 45 preterm neonates with intraventricular hemorrhage (IVH) who were delivered vaginally with intravenous meperidine (n = 23) or epidural analgesia (n = 22). Neonates in the epidural group had a better outcome in terms of a first-minute Apgar score of 7 or less, in 31% vs 69% (P = 0.001); 5-min Apgar score of 7 or less, in 18% vs 82% (P = 0.003); a lower incidence of respiratory distress syndrome (RDS; 23% vs 30%; P = 0.03); a lower dopamine requirement during the first neonatal week (13% vs 72%; P = 0.01); and a higher survival rate (91% vs 58%, respectively; P = 0.008). It is concluded that preterm neonates with IVH had a better outcome when delivered to mothers receiving epidural analgesia as compared to those receiving intravenous meperidine.

MeSH terms

  • Adult
  • Analgesia, Epidural / adverse effects*
  • Analgesia, Epidural / methods
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Anesthesia, Intravenous / adverse effects*
  • Anesthesia, Intravenous / methods
  • Anesthesia, Obstetrical / adverse effects*
  • Anesthesia, Obstetrical / methods
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / adverse effects
  • Apgar Score
  • Bupivacaine / administration & dosage
  • Bupivacaine / adverse effects
  • Cerebral Hemorrhage / epidemiology*
  • Cerebral Ventricles
  • Comorbidity
  • Dopamine / administration & dosage
  • Dopamine Agents / administration & dosage
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Premature*
  • Meperidine / administration & dosage
  • Meperidine / adverse effects*
  • Mothers
  • Pregnancy
  • Respiratory Distress Syndrome, Newborn / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Survival Rate

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Dopamine Agents
  • Meperidine
  • Dopamine
  • Bupivacaine