"Drug-related side-effectsThere are a number of drug-related side-effects associated with epidural opioids and local anaesthetic agents.
OpioidsRespiratory depression: this is due to the action of opioids on the respiratory centre. Respiratory depression may occur at two different time intervals.
- Early: usually within 2 hours of the opioid injection. This may occur if high blood levels of the opioid follow absorption from the epidural space into the systemic circulation (Macintyre & Ready 2001)."
----- Original Message ----- From: "Helen and Graham" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au> Sent: Tuesday, December 12, 2006 10:34 PM Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream
http://www.blackwellroyalmarsdenmanual.com/sample/mars29.htmThe above link is a very in depth look at epidural drugs and their mode of action.Helen----- Original Message ----- From: "Kelly Zantey" <[EMAIL PROTECTED]>To: <ozmidwifery@acegraphics.com.au> Sent: Tuesday, December 12, 2006 8:57 PM Subject: RE: [ozmidwifery] Epidurals - entering the bloodstreamThey are very well referenced, which is why I was surprised when she challenged me on it as I knew Sarah uses lots of references (her articles are on my site) - but if you read the bit about the drugs going into the bloodstream there is no reference for that. Here's the discussion, might be easier to understand. I'm not arguing the point, but want something solid to come back to her with. http://www.bellybelly.com.au/forums/showthread.php?t=26236 -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Cate Tischler Sent: Tuesday, December 12, 2006 8:35 PM To: ozmidwifery@acegraphics.com.au Cc: Kelly Zantey Subject: RE: [ozmidwifery] Epidurals - entering the bloodstreamSarah's article's are so well referenced. One of the reference's includedis: 25) Fernando R, Bonello E et al. Placental and maternal plasmaconcentrations of fentanyl and bupivicaine after ambulatory combined spinal epidural (CSE) analgesia during labour. Int J Obstet Anaesth 1995;4:178-179From here: http://onyx-ii.com/birthsong/page.cfm?epidural ---- Kelly Zantey <[EMAIL PROTECTED]> wrote:Thanks Janet - a few of those links are not working.The main thing she wants is actual medical study/evidence articles - e.g.the Sarah Buckley article she says is not adequate as the comment aboutthedrug going into the bloodstream is not referenced back to anything. shehasbeen trying to find such evidence everywhere but it has turned upfruitful.So not just the risks being quoted, but actual evidence. Oh well, if it does it for them then that's what we have to do :-) _____ From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Tuesday, December 12, 2006 4:49 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] Epidurals - entering the bloodstream Here are some useful sources for the risks of epidurals. Funny how womenaretold to avoid alcohol and soft cheeses in pregnancy but encouraged toimbibepowerful and dangerous drugs in labour. Drugs in labour twenty years hence. <http://www.midwiferytoday.com/artic...ugsinlabour.asp> http://www.midwiferytoday.com/artic...ugsinlabour.asp epidural information <http://gentlebirth.org/Midwife/epirisks.html> http://gentlebirth.org/Midwife/epirisks.html A little excerpt Quote:Generally, it is true to say the epidurals are a safe and effective method of relieving pain in labour - but safe does not mean risk free - the risks are there - it is wrong to say there are "none" (re the hospital employedchildbirth educator) See Thorp, J.A. & Breedlove, G (1996) EpiduralAnalgesia in Labour: An evaluation of Risks and Benefits 23(2) 63-83. foragood review of the literature. . hypotension 12 - 23% . maternal fever - (then unnecessary antibiotic therapy - then the yeast infection - then.....) one study cited an increase of 0.07 Celsius riseperhour exposure to epidural anesthesia. another reported 5% of fetusesreachedcores temp in excess of 4Celsius, another found a statisticallysignificantincrease in maternal temps > 38C associated with EA. . inadvertent spinal ( and headache to follow - which a blood patch doesnotalways cure - the incidence depends on skill of operator.... July - new residents - expect a huge increase in spinals in the teachinghospitals.....) . pruritus, nausea and vomiting. (no numbers here - but more likely with spinals) . backache - significant more women c/o backache following EA (RR 1. . fluid overload- ?pulmonary edema??? . infection from epidural site . resp arrest . anaphylaxis . nerve damage Henci Goer on epidurals <http://parenting.ivillage.com/pregn...a=adid=16053332> http://parenting.ivillage.com/pregn...a=adid=16053332 Epidurals: can they impact breastfeeding? <http://parenting.ivillage.com/pregn...0,,h1nz,00.html> http://parenting.ivillage.com/pregn...0,,h1nz,00.html Epidurals: real risk for mother and baby - Sarah Buckley <http://www.acegraphics.com.au/articles/sarah02.html> http://www.acegraphics.com.au/articles/sarah02.html The Epidural Express: Real Reasons Not to Jump On Board by Nancy Griffin, M.A., AAHCC <http://birthrites.edsite.com.au/Epidural.html> http://birthrites.edsite.com.au/Epidural.html Medical Risks of Epidural Anesthesia During Childbirth <http://www.healing-arts.org/mehl-madrona/mmepidural.htm> http://www.healing-arts.org/mehl-madrona/mmepidural.htm----- Original Message -----From: Kelly <mailto:[EMAIL PROTECTED]> Zantey To: ozmidwifery@acegraphics.com.au Sent: Tuesday, December 12, 2006 4:42 PM Subject: [ozmidwifery] Epidurals - entering the bloodstream Hello, Can anyone point me to a medical source or evidence which proves thatepidural anaesthesia enters the bloodstream? Someone in my forums has saidshe has tried to find medical sources but can't find them anywhere. Best Regards, Kelly Zantey-- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. __________ NOD32 1916 (20061212) Information __________ This message was checked by NOD32 antivirus system. http://www.eset.com-- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. __________ NOD32 1918 (20061212) Information __________ This message was checked by NOD32 antivirus system. http://www.eset.com
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