Neonatal Patterns of Breathing after Cesarean Section with or without Epidural Fentanyl

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Abstract
The pattern of breathing and lung mechanics were evaluated during the first 7 h of life in full-term healthy newborns delivered by cesarrean section with bupivacaine epideural anesthesia, without (group 1) or with the addition of 100 .mu.g of fentanyl (group 2). Respiration and oxyhemoglobin saturtion (SpO2) were measured with calibrated inductive plethysmography and pulse oximetry, respectively, and recorded from 60-420 min following birth. Compliance of respiratory system (CRS) was measured using a multiple occlusion technique at 60 and 420 min. Pattern of breathing was compared during period I (60-240 min) and II (240-420 min) with the following results: 1) the number of apnea spells was similar in both groups during both periods; 2) in both groups, from period I to period II a significant decrease in apnea duration was observed (7.6 .+-. 0.7 s-4.1 .+-. 0.5 s in group 1 and 6.7 .+-. 1.2 s-5.1 .+-. 1.0 s in group 2, respectively (P < 0.05); 3) respiratory rate (RR) and minute ventilation (SD+VE) were similar in both groups during both study periods; and 4) both RR and .ovrhdot.VE significantly decreased in the two groups from period I to period II (i.e., 59 .+-. 5-46 .+-. 2 breath per min-1 and 313 .+-. 60-248 .+-. 24 ml .cntdot. kg-1 .cntdot. min-1 in group 1, and 60 .+-. 2-51 .+-. 1 breath .cntdot. min-1 and 318 .+-. 12-ml .cntdot. kg-1 .cntdot. min-1 in group 2, respectively; P < 0.05). For newborns without aphnea breathing room air. Spo2 was always greater than 95%, and the lowest Spo2 after the occurrence of apnea was never less than 91%. Between both groups, CRS were similar at 60 or 420 min but significantly increased in each group (P < 0.05) from 60-420 min (i.e. 0.59 .+-. 0.19 - 0.72 .+-. 0.12 ml .cntdot. kg-1 .cntdot. cmH2O-1 in group 1 and 0.54 .+-. 0.12-0.67 .+-. 0.14 ml .cntdot. kg-1 .cntdot. cmH2O-1 in group 2, respectively). The authors concluded thta in healthy newborns, no respiratory impairment occurred during the first 7 h of life after cesarean section for which epidural fentanyl had been administered to the mother.