{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T08:15:02Z","timestamp":1761725702199,"version":"build-2065373602"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T00:00:00Z","timestamp":1522022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Hospital Research Ethics Committee","award":["NK\/336\/MD\/9773-74"],"award-info":[{"award-number":["NK\/336\/MD\/9773-74"]}]},{"name":"ClinicalTrials.gov","award":["CTRI\/2015\/08\/006144"],"award-info":[{"award-number":["CTRI\/2015\/08\/006144"]}]}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>The mechanism for fetal heart rate abnormalities following spinal opioids remains controversial. We evaluated uterine tone, using an intra\u2010uterine pressure catheter, and fetal heart rate abnormalities in 30 women in spontaneous labour with cervical dilation of 3\u20135 cm having combined spinal\u2010epidural analgesia. Women were randomly assigned to receive a spinal with 2.0 mg hyperbaric bupivacaine plus 15 \u03bcg fentanyl, or 2.5 mg hyperbaric bupivacaine. The primary outcome measure was an increase &gt; 10 mmHg in baseline uterine tone in the 30\u2010min period following spinal injection. Only three (20%) women who had a bupivacaine\u2013fentanyl spinal showed a &gt; 10 mmHg increase in baseline tone vs. none who had bupivacaine (p = 0.63). The mean (SD) baseline uterine tone after the spinal injection was 13.3 (7.0) mmHg in the bupivacaine\u2013fentanyl group and 7.7 (2.5) mmHg in the bupivacaine group (p = 0.01). Seven (47%) in the bupivacaine\u2013fentanyl group showed new onset fetal heart rate changes during the 30\u2010min period after the spinal, compared with two (13%) in the bupivacaine group (p = 0.04); however, these were transient and responded to intra\u2010uterine resuscitation. Pain scores, sensory and motor block as well as neonatal outcomes were comparable between the groups. We found that raised baseline uterine tone was not more frequent when using bupivacaine\u2013fentanyl rather than bupivacaine in the spinal component of combined spinal\u2010epidural, although absolute values of baseline tone were higher, and fetal heart rate changes more frequent, in the former group.<\/jats:p>","DOI":"10.1111\/anae.14278","type":"journal-article","created":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T00:39:33Z","timestamp":1522111173000},"page":"832-838","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The effect of spinal hyperbaric bupivacaine\u2013fentanyl or hyperbaric bupivacaine on uterine tone and fetal heart rate in labouring women: a randomised controlled study"],"prefix":"10.1111","volume":"73","author":[{"given":"A.","family":"Kuberan","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Postgraduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Bagga","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Post Graduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. K.","family":"Makkar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Post Graduate Institute of Medical Education and Research Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,3,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/71.4.499"},{"key":"e_1_2_6_3_1","first-page":"191","article-title":"Spinal analgesia during labor with low\u2010dose bupivacaine, sufentanil, and epinephrine. A comparison with epidural analgesia","volume":"21","author":"Kartawiadi L","year":"1996","journal-title":"Regional Anesthesia"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)92602-X"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199610000-00014"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199903000-00021"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2007.01.009"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(98)70266-2"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199712113372402"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1054\/ijoa.2000.0746"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199410000-00041"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200105000-00010"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000101980.34587.66"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818f5eb6"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181a8909d"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2010.06616.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199311000-00008"},{"key":"e_1_2_6_18_1","unstructured":"National Institute for Health and Care Excellence.Intrapartum care: care of healthy women and their babies during childbirth (clinical guideline 55).2007.http:\/\/www.nice.org.uk\/CG55(accessed 15\/2\/2018)."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2002.01380.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001412"},{"key":"e_1_2_6_21_1","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1213\/00000539-199810000-00022","article-title":"The tocolytic effect of cathecholamines in the gravid rat uterus","volume":"87","author":"Segall S","year":"1998","journal-title":"Anesthesia and Analgesia"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12602"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12833"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200003000-00033"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200104000-00011"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200503000-00025"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03021894"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0265021508004183"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2004.12.010"},{"key":"e_1_2_6_30_1","first-page":"39","article-title":"Labor analgesia: a comparative study between combined spinal\u2010epidural anesthesia vs. continuous epidural anesthesia","volume":"57","author":"Cortes CAF","year":"2007","journal-title":"Revista Brasileira de Anestesiologia"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanae.14278","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.14278","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T01:10:06Z","timestamp":1761700206000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.14278"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,26]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1111\/anae.14278"],"URL":"https:\/\/doi.org\/10.1111\/anae.14278","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"type":"print","value":"0003-2409"},{"type":"electronic","value":"1365-2044"}],"subject":[],"published":{"date-parts":[[2018,3,26]]},"assertion":[{"value":"2018-02-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}