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EFFECTS OF EPIDURAL AND INTRAVENOUS REMIFENTANIL ANALGESIA DURING LABOR ON NEONATAL OUTCOME - RETROSPECTIVE OBSERVATIONAL STUDY
Author(s): ,
Sobot Novakovic , S.*
Affiliations:
University Clinical Center of Republic of Srpska, Department of Anesthesiology and Intensive Care Unit, Banja Luka, Bosnia - Herzegovina
,
Cuk , S.
Affiliations:
University Clinical Center of Republic of Srpska, Department of Anesthesiology and Intensive Care Unit, Banja Luka, Bosnia - Herzegovina
,
Lazic , G.
Affiliations:
University Clinical Center of Republic of Srpska, Department of Anesthesiology and Intensive Care Unit, Banja Luka, Bosnia - Herzegovina
,
Rakanovic , D.
Affiliations:
University Clinical Center of Republic of Srpska, Department of Anesthesiology and Intensive Care Unit, Banja Luka, Bosnia - Herzegovina
,
Ceric Banicevic , A.
Affiliations:
University Clinical Center of Republic of Srpska, Department of Gynecology and Obstetrics, Banja Luka, Bosnia - Herzegovina
,
Draganovic , D.
Affiliations:
University Clinical Center of Republic of Srpska, Department of Gynecology and Obstetrics, Banja Luka, Bosnia - Herzegovina
Visekruna , L.
Affiliations:
University Clinical Center of Republic of Srpska, Department of Pediatrics, Banja Luka, Bosnia - Herzegovina
ESRA Academy. Sobot S. Sep 13, 2017; 190804; 139
Suzana Sobot
Suzana Sobot

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Abstract
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Background and Aims:

We evaluated the clinical outcome of term neonates born to mothers who received epidural analgesia (E) or systemic analgesia with remifentanil (R) during labor.

Methods:

Data was collected retrospectively over the course of one year. We have evaluated the medical records of 247 full term neonates, 208 were born to mothers who received E and 39 to mothers who received R. Data on Apgar scores and perinatal complications (infection, sepsis, hyperbilirubinemia, perinatal injuries, asphyxia), and average hospital stay were collected. Mann-Whitney U test, chi square test, and logistic regression analysis were used where appropriate.

Results:

Mean Apgar scores in 1st and 5th minute between E and R were similar (8.83 vs. 8.97 P = 0.252; 9.81 vs. 9.87, P = 0.762, respectively). Average neonatal hospital stay was not different between groups (4.19 vs. 4, P = 0.557). The percentage of neonates with any perinatal complication were similar between groups (28.3% vs. 32.5%, P = 0.598). Neonates born by cesarean delivery (CD) had statistically significant worse outcomes compared to neonates that were delivered vaginally (odds ratio 2.8 95%CI [1.30647-6.17692]).


Conclusions:

We did not find statistically significant difference in mean Apgar scores and perinatal complications between neonates who received epidural vs. remifentanil analgesia  We measured an increased rate of complications in neonates born via CD. Fetal indications for CD may be a significant confounder explaining this finding. Future studies should have a greater sample size and be powered to detect such associations.

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