Puhto, T., Kokki, M., Hakomäki, H. et al. Single dose epidural hydromorphone in labour pain: maternal pharmacokinetics and neonatal exposure. Eur J Clin Pharmacol 76, 969–977 (2020). https://doi.org/10.1007/s00228-020-02880-6
Single dose epidural hydromorphone in labour pain : maternal pharmacokinetics and neonatal exposure
|Author:||Puhto, Terhi1; Kokki, Merja2; Hakomäki, Henriikka3;|
1Department of Anaesthesiology, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital, PO Box 21, 90029, Oulu, Finland
2Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland
3School of Pharmacy, University of Eastern Finland, Kuopio, Finland
4Forensic Toxicology Unit (THL), The Finnish Institute for Health and Welfare, Helsinki, Finland
|Online Access:||PDF Full Text (PDF, 1 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2020101584113
|Publish Date:|| 2020-10-15
Introduction: Epidural hydromorphone could be useful in obstetric analgesia as there is a need for a more water-soluble opioid than sufentanil or fentanyl with prolonged analgesic effect. To our knowledge, the pharmacokinetics of epidural hydromorphone has not been evaluated in parturients.
Materials and methods: In this pilot study, seven healthy parturients were given a single epidural dose of hydromorphone for labour pain. One parturient received 1.5 mg, two 0.75 mg and four 0.5 mg of hydromorphone hydrochloride. Dose was decreased due to nausea and pruritus. Hydromorphone’s effect, adverse effects and plasma concentrations were evaluated. Neonatal drug exposure was evaluated by umbilical vein and artery opioid concentration at birth. Neonatal outcomes were assessed using Apgar and the Neurologic Adaptive Capacity Score (NACS).
Results: All patients received additional levobupivacaine doses on parturients’ requests. The first dose was requested at a median of 163 min (range 19–303 min) after hydromorphone administration. A total of 12 opioid related expected adverse events were reported by seven parturients. All newborn outcomes were uneventful. Hydromorphone’s distribution and elimination after single epidural dose seem similar to that reported for non-pregnant subjects after intravenous hydromorphone administration, but further research is required to confirm this observation.
Conclusions: The optimal dose of hydromorphone in labour pain warrants further evaluation.
European journal of clinical pharmacology
|Pages:||969 - 977|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3123 Gynaecology and paediatrics
Costs of laboratory analysis in this study have been supported by the Oulu medical Research Foundation (Oulu, Finland).
© The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.