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Published on: August 19, 2020
Effect of Epidural Analgesia During Low-Risk Labor and Delivery on Cerebral Oximetry in Term Neonates Measured by
María Teresa Gómez-Riesco Tabernero de Paz1, Ana Garzón-Sánchez2, Carlos Ricardo Vargas-Chiarella3
1Department of Nursing and Physiotherapy, University of Salamanca, 37007 Salamanca, Spain.
Background: Epidural obstetric analgesia is the standard of care for labor pain relief; however, its impact on neonatal cerebral oximetry remains debated. Objective: We aimed to evaluate whether epidural analgesia modifies cerebral regional oxygen saturation (CrSO2), measured by near-infrared spectroscopy (NIRS), in term neonates from low-risk deliveries. Methods: We conducted a prospective comparative observational cohort study, including 48 term newborns: 25 delivered under epidural analgesia (EA) and 23 without epidural analgesia (NE). CrSO2 was monitored using NIRS (INVOS 5100C, Somanetics/Medtronic, Troy, MI, USA; OxyAlert NIRSensor Cerebral/Somatic Infant-Neonatal Sensor CNN/SNN) during the neonatal transition up to 15 min after birth (primary outcome), and its relationship with neonatal well-being parameters (umbilical cord pH, Apgar score, and other analytical and obstetric indicators) was explored. Results: Median CrSO2 at 15 min was 79.52 [76.40-82.64] in the EA group and 78.65 [74.21-83.09] in the NE group. Both groups exhibited a similar temporal pattern characterized by a progressive increase, a peak at 10 min, and stabilization by 15 min. Mean (SD) CrSO2 in EA/NE were: 2 min, 57.64 (14.8)/60.04 (14.4); 5 min, 79.56 (10.9)/79.39 (12.2); 10 min, 82.28 (8.1)/81.13 (9.7); 15 min, 79.52 (7.6)/78.65 (10.3). No significant between-group differences were detected at any time point using a linear mixed model (p-values: 2 min, 0.57; 5 min, 0.96; 10 min, 0.66; 15 min, 0.74). Conclusions: These findings indicate that epidural obstetric analgesia does not alter cerebral oximetry parameters in term neonates from low-risk deliveries during the early transitional period.
Background: Epidural obstetric analgesia is the standard of care for labor pain relief; however, its impact on neonatal cerebral oximetry remains debated. Objective: We aimed to evaluate whether epidural analgesia modifies cerebral regional oxygen saturation (CrSO2), measured by near-infrared spectroscopy (NIRS), in term neonates from low-risk deliveries. Methods: We conducted a prospective comparative observational cohort study, including 48 term newborns: 25 delivered under epidural analgesia (EA) and 23 without epidural analgesia (NE). CrSO2 was monitored using NIRS (INVOS 5100C, Somanetics/Medtronic, Troy, MI, USA; OxyAlert NIRSensor Cerebral/Somatic Infant-Neonatal Sensor CNN/SNN) during the neonatal transition up to 15 min after birth (primary outcome), and its relationship with neonatal well-being parameters (umbilical cord pH, Apgar score, and other analytical and obstetric indicators) was explored. Results: Median CrSO2 at 15 min was 79.52 [76.40-82.64] in the EA group and 78.65 [74.21-83.09] in the NE group. Both groups exhibited a similar temporal pattern characterized by a progressive increase, a peak at 10 min, and stabilization by 15 min. Mean (SD) CrSO2 in EA/NE were: 2 min, 57.64 (14.8)/60.04 (14.4); 5 min, 79.56 (10.9)/79.39 (12.2); 10 min, 82.28 (8.1)/81.13 (9.7); 15 min, 79.52 (7.6)/78.65 (10.3). No significant between-group differences were detected at any time point using a linear mixed model (p-values: 2 min, 0.57; 5 min, 0.96; 10 min, 0.66; 15 min, 0.74). Conclusions: These findings indicate that epidural obstetric analgesia does not alter cerebral oximetry parameters in term neonates from low-risk deliveries during the early transitional period.
