( Can J Anesth . 2025 Jun;72:934-944. doi: 10.1007/s12630-025-02975-7.) Epidural analgesia during labor can consist of both local anesthetics and opioids, and can be administered either on demand, through continuous infusion, or through programmed intermittent epidural bolus (PIEB) or patient-controlled epidural analgesia (PCEA). Previous literature has shown that the use of PIEB and PCEA can result in less motor block, decreased intervention, and improved patient satisfaction. Though these methods have benefits for the mother, high neonatal concentrations of analgesic drugs can cause side effects such as respiratory depression; previous literature has not characterized the umbilical venous concentrations of analgesic drugs after vaginal birth (VB). This study was designed to assess umbilical venous concentrations of ropivacaine and fentanyl in neonates at VB after a combination of PIEB with PCEA and clinician-administered boluses, as well as assess the relationship between these concentrations and the need for neonatal respiratory support immediately after VB.
Ijuin et al. (Sun,) studied this question.