Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in Neonates

Meng Cai,1 Hao Liu,2 Yong Peng,2 Jing-Kun Miao,2 Xiao-Feng Lei,1 Jin Yu1 1Department of Anesthesiology, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Pediatrics, Chongqing Health Ce...

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Main Authors: Cai M, Liu H, Peng Y, Miao JK, Lei XF, Yu J
Format: Article
Language:English
Published: Dove Medical Press 2023-05-01
Series:Drug Design, Development and Therapy
Subjects:
Online Access:https://www.dovepress.com/prolonged-anesthesia-induction-to-delivery-time-did-not-influence-plas-peer-reviewed-fulltext-article-DDDT
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author Cai M
Liu H
Peng Y
Miao JK
Lei XF
Yu J
author_facet Cai M
Liu H
Peng Y
Miao JK
Lei XF
Yu J
author_sort Cai M
collection DOAJ
description Meng Cai,1 Hao Liu,2 Yong Peng,2 Jing-Kun Miao,2 Xiao-Feng Lei,1 Jin Yu1 1Department of Anesthesiology, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Pediatrics, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Jin Yu, Department of Anesthesiology, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, No. 120, Longshan Road, Yubei District, Chongqing, 401147, People’s Republic of China, Tel +86-18623117820, Email dodoes@qq.comObjective: Remifentanil, in combination with etomidate and sevoflurane, is commonly used in clinics for general anesthesia induction in cesarean section (CS). This study aimed to evaluate the correlation between the induction to delivery (I-D) time and neonatal plasma drug concentration and anesthesia, as well as its effects on neonates.Methods: Fifty-two parturients in whom general anesthesia was induced for CS were divided into group A (I-D< 8 min) and group B (I-D≥ 8 min). Maternal arterial (MA), umbilical venous (UV), and umbilical arterial (UA) blood samples were collected at delivery to analyze the remifentanil and etomidate concentrations using liquid chromatography-tandem mass spectrometry.Results: There were no statistically significant differences between the two groups in terms of plasma concentrations of remifentanil in the MA, UA, and UV blood (P > 0.05). The plasma concentration of etomidate in MA and UV was higher in group A than that in group B (P< 0.05), whereas the UA/UV ratio of etomidate was higher in group B than that in group A (P< 0.05). The Spearman rank correlation test showed no correlation between the I-D time and plasma remifentanil concentration in the MA, UA, and UV plasma (P> 0.05). The concentrations of etomidate in the MA and UV were negatively correlated with the I-D time (P < 0.05).Conclusion: Prolonged I-D time did not significantly influence the maternal or neonatal plasma concentration of remifentanil. It is safe to administer remifentanil target-controlled infusion in combination with etomidate and sevoflurane for general anesthesia induction during CS.Keywords: cesarean section, placental transport, general anesthesia, remifentanil, etomidate, drug concentration
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spelling doaj.art-a5ad31ce93764339b47caad2cf6724f22023-05-09T18:57:55ZengDove Medical PressDrug Design, Development and Therapy1177-88812023-05-01Volume 171395140383585Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in NeonatesCai MLiu HPeng YMiao JKLei XFYu JMeng Cai,1 Hao Liu,2 Yong Peng,2 Jing-Kun Miao,2 Xiao-Feng Lei,1 Jin Yu1 1Department of Anesthesiology, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 2Department of Pediatrics, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Jin Yu, Department of Anesthesiology, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical University, No. 120, Longshan Road, Yubei District, Chongqing, 401147, People’s Republic of China, Tel +86-18623117820, Email dodoes@qq.comObjective: Remifentanil, in combination with etomidate and sevoflurane, is commonly used in clinics for general anesthesia induction in cesarean section (CS). This study aimed to evaluate the correlation between the induction to delivery (I-D) time and neonatal plasma drug concentration and anesthesia, as well as its effects on neonates.Methods: Fifty-two parturients in whom general anesthesia was induced for CS were divided into group A (I-D< 8 min) and group B (I-D≥ 8 min). Maternal arterial (MA), umbilical venous (UV), and umbilical arterial (UA) blood samples were collected at delivery to analyze the remifentanil and etomidate concentrations using liquid chromatography-tandem mass spectrometry.Results: There were no statistically significant differences between the two groups in terms of plasma concentrations of remifentanil in the MA, UA, and UV blood (P > 0.05). The plasma concentration of etomidate in MA and UV was higher in group A than that in group B (P< 0.05), whereas the UA/UV ratio of etomidate was higher in group B than that in group A (P< 0.05). The Spearman rank correlation test showed no correlation between the I-D time and plasma remifentanil concentration in the MA, UA, and UV plasma (P> 0.05). The concentrations of etomidate in the MA and UV were negatively correlated with the I-D time (P < 0.05).Conclusion: Prolonged I-D time did not significantly influence the maternal or neonatal plasma concentration of remifentanil. It is safe to administer remifentanil target-controlled infusion in combination with etomidate and sevoflurane for general anesthesia induction during CS.Keywords: cesarean section, placental transport, general anesthesia, remifentanil, etomidate, drug concentrationhttps://www.dovepress.com/prolonged-anesthesia-induction-to-delivery-time-did-not-influence-plas-peer-reviewed-fulltext-article-DDDTcesarean sectionplacental transportgeneral anesthesiaremifentaniletomidatedrug concentration
spellingShingle Cai M
Liu H
Peng Y
Miao JK
Lei XF
Yu J
Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in Neonates
Drug Design, Development and Therapy
cesarean section
placental transport
general anesthesia
remifentanil
etomidate
drug concentration
title Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in Neonates
title_full Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in Neonates
title_fullStr Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in Neonates
title_full_unstemmed Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in Neonates
title_short Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in Neonates
title_sort prolonged anesthesia induction to delivery time did not influence plasma remifentanil concentration in neonates
topic cesarean section
placental transport
general anesthesia
remifentanil
etomidate
drug concentration
url https://www.dovepress.com/prolonged-anesthesia-induction-to-delivery-time-did-not-influence-plas-peer-reviewed-fulltext-article-DDDT
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