The maternal and fetal cardiovascular effects of epidural morphine in the sheep model

Am J Obstet Gynecol. 1982 Apr 1;142(7):835-9. doi: 10.1016/s0002-9378(16)32528-5.

Abstract

Interest in the use of epidural narcotics for analgesia has been widespread since the demonstration of opiate receptors in the spinal cord in the mid nineteen-seventies. Recently, several studies have attempted to evaluate the effectiveness of epidural narcotics for the relief of pain in labor and after cesarean section. Using the chronically catheterized maternal-fetal sheep model, we injected 5 mg of preservative-free morphine into the epidural space. No statistically significant changes were observed, neither in maternal or fetal arterial pressure and acid-base status, nor in maternal central venous pressure, systemic and pulmonary vascular resistance, cardiac output, or intrauterine pressure (p greater than 0.05). There was a significant, although small, decrease in maternal heart rate (8%) and uterine blood flow (9%) at 120 minutes (p less than 0.05), and then a return to control values. The maternal levels of morphine peaked at 15 minutes (29 ng/ml) and the fetal levels of morphine peaked at 90 minutes (3 to 4 ng/ml). We conclude that the injection of 5 mg of morphine into the maternal epidural space has no adverse effect on mother or fetus in the sheep model.

Publication types

  • Comparative Study

MeSH terms

  • Acid-Base Equilibrium
  • Anesthesia, Epidural*
  • Anesthesia, Obstetrical*
  • Animals
  • Blood Pressure / drug effects
  • Cardiac Output / drug effects
  • Female
  • Fetal Heart / drug effects
  • Fetus / drug effects*
  • Fetus / physiology
  • Hemodynamics / drug effects*
  • Maternal-Fetal Exchange
  • Morphine / administration & dosage
  • Morphine / pharmacology*
  • Pregnancy
  • Pulmonary Circulation / drug effects
  • Sheep
  • Uterus / blood supply
  • Vascular Resistance / drug effects

Substances

  • Morphine