Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC19310.15690/vramn.v68i4.608ANAESTHESIOLOGY AND CRITICAL CARE MEDICINE: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ АНЕСТЕЗИОЛОГИИ И РЕАНИМАТОЛОГИИTHE INFLUENCE OF THE BUPIVACAINE REGIONAL ANESTHESIA ON THE CONTRACTILE ACTIVITY OF THE UTERUS AND THE FUNCTIONAL STATE OF THE FETUSВЛИЯНИЕ РЕГИОНАРНОЙ АНЕСТЕЗИИ БУПИВАКАИНОМ НА СОКРАТИТЕЛЬНУЮ АКТИВНОСТЬ МАТКИ И ФУНКЦИОНАЛЬНОЕ СОСТОЯНИЕ ПЛОДАBazizyanE. V.БазиянЕ. В.
Russian Federation

Research Worker, Laboratory of Physiology and Pathophysiology of Fetus with Ultrasound Department, Research Institute of Obstetrics and Gynecology named after D.O. Otta Address: 199034, St. Petersburg, Mendeleev line 3; tel.: (812) 328-98-14

waz2107gen@yandex.ruKonstantinovaN. N.КонстантиноваН. Н.
Russian Federation

PhD, Professor, Leading Research Worker, Laboratory of Physiology and Pathophysiology of Fetus with Ultrasound Department, Research Institute of Obstetrics and Gynecology named after D.O. Otta Address: 199034, St. Petersburg, Mendeleev line 3; tel.: (812) 328-98-14

ngp05@yandex.ruNazarovaL. A.НазароваЛ. А.

PhD, Senior Research Worker, Laboratory of Physiology and Pathophysiology of Fetus with Ultrasound Department, Research Institute of Obstetrics and Gynecology named after D.O. Otta Address: 199034, St. Petersburg, Mendeleev line 3; tel.: (812) 328-98-14

ngp05@yandex.ruPervakV. A.ПервакВ. А.
Russian Federation

PhD, Physician of the Anesthesiology, Reanimation and Intensive Therapy Department, Research Institute of Obstetrics and Gynecology named after D.O. Otta Address: 199034, St. Petersburg, Mendeleev line 3; tel.: (812) 328-98-14

med-tehno@yandex.ruPavlovaN. G.ПавловаН. Г.
Russian Federation

PhD, Professor, Head of the Laboratory of Physiology and Pathophysiology of Fetus with Ultrasound Department, Research Institute of Obstetrics and Gynecology named after D.O. Otta Address: 199034, St. Petersburg, Mendeleev line 3; tel.: (812) 328-98-14

ngp05@yandex.ruOtt Institute of Obstetrics and Gynecology, Saint-Petersburg, Russian FederationНаучно-исследовательский институт акушерства и гинекологии им. Д.О. Отта, Санкт-Петербург, Российская Федерация14042013684Vestnik Rossiiskoi akademii medetsinskikh nauk / Annals of the Russian academy of medical sciencesВестник Российской академии медицинских наук303507082015Copyright ©; 1970, "Paediatrician" Publishers LLCCopyright ©; 1970, Издательство "Педиатръ"1970"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/article/view/193

The study in chronic experiment on 26 pregnant rabbit females induced in labor by oxytocin on the 30th day of pregnancy was conducted. The effects of bupivacaine (0,5% - 1 ml) epidural anesthesia (EA) on the contractile activity of the uterus, the functional state of the females and their fetuses were studied. On the 28th day of pregnancy under thiopental anesthesia electrodes were administered: to the fetus - ECG, in the female myometrium - for recording electrical activity. In order to check the uterus mechanical activity the original sensor was used filled by graphite, which was placed around one horn of the uterus. The contractile activity of the myometrium was evaluated for each 5-minute interval by the number of uterine contractions, duration and amplitude of one uterine contraction. The functional state of female fetuses and rabbit female were evaluated by the frequency change of the heart rate. In 12 females occured to delivery. Registration of uterine contractions, heart rate of the female and fetuses were carried out simultaneously and continuously throughout the whole experiment. It was shown that under standard conditions EA didn’t induce changes in uterine activity parameters of the female located in its natural position, and didn’t affect on the fetal heart rate (3-factor analysis of variance - ANOVA). 10 minutes after EA, the momentary acceleration of female heart rate (9%) was recorded in relation to the reference level, which may be associated with transient hypotension. Thus, in conditions of our experience the bupivacaine (0,5% -1,0 ml) EA in induced labor of female rabbit has no significant effect on the uterus contractile activity and the functional state of the fetus. Short-term adaptive tachycardia is registered in females.

Исследование проведено в хроническом опыте на 26 беременных самках кролика в индуцированных окситоцином на 30-й день беременности родах. Изучали влияние эпидуральной анестезии (ЭА) бупивакаином (0,5% – 1 мл) на сократительную активность матки, функциональное состояние самки и их плодов. На 28-й день беременности под тиопенталовым наркозом плодам вводили ЭКГ-электроды; в миометрий – электроды для регистрации электрической активности матки. С целью регистрации механической активности матки применяли оригинальный резиновый датчик в виде манжетки, заполненной графитом, который помещали вокруг одного рога матки. Сократительную активность миометрия оценивали по количеству маточных сокращений, продолжительности и амплитуде одного маточного сокращения за каждый 5-минутный интервал, функциональное состояние плодов и самки – по изменению частоты их сердечных сокращений. У 12 самок в динамике эксперимента наблюдалось родоразрешение. Регистрацию сокращений матки, частоты сердечных сокращений самки и плодов проводили непрерывно и синхронно в течение опыта. Результаты показали, что в стандартных условиях опыта ЭА не вызывала изменений параметров сократительной активности матки самки кролика, находящейся в естественном положении, и не влияла на частоту сердечных сокращений плодов (3-факторный дисперсионный анализ ANOVA). Через 10 минут после ЭА у самок кролика возникало кратковременное учащение сердечных сокращений (на 9%) по отношению к исходному уровню, что может быть связано с транзиторной гипотонией. Таким образом, ЭА, выполненная бупивакаином (0,5%-1,0 мл) в индуцированных родах самкам кролика, в условиях нашего опыта не оказывала значимого влияния на сократительную активность матки и функциональное состояние плодов. Зарегистрирована кратковременная адаптивная тахикардия у самок.

marcaine epidural anesthesiauterine contractionsfetal heart beatingэпидуральная анестезиябупивакаинэлектромиография маткифункциональное состояние плода1. Nazarova L.A., Konstantinova N.N., Tolibova G.Kh., Baziyan E.V., Morozov G.B. Uterine activity rabbits in late pregnancy and the method of its registration. Byull. eksp. biol. i meditsiny = Bulletin of experimental biology and medicine. 2007; 144 (9): 355–357.2. Pervak V.A., Nazarova L.A., Konstantinova N.N., Baziyan E.V. Eksperimental'naya model' epidural'noi anestezii u samok krolika. Nauchn. konf.: Fundamental'naya nauka i klinicheskaya meditsina [Experimental Model of Epidural Anesthesia in Rabbits. Scientific Conference: Basic Science and Clinical Medicine]. St. Petersburg, 2007. p. 86–87.3. Eltzschhing H.K., Liberman E.S., Camann W.R. Regional anesthesia and analgesia for labor and delivery. N. Engl. J. Med. 2003; 348: 319–332.4. Chapelle A., Carles M., Gleize, Dellamonica J., Lallia A., Bongain A., Raucoules-Aime M.. Impact of walking epidural analgesia on obstetric outcome of nulliparous women in spontaneous labor. Int. J. Obstet. Anesthesia. 2006; 15: 104–108.5. Тhorp J.А. Epidural analgesia during lаbоr. Clin. Obstet. Gynecol. 1999; 42:785–801.6. Shifman E.M., Ermilov Yu.N. Effect of epidural analgesia on the course of labor. Ross. vestn. akushera-ginekologa – Russian bulletin of obstetrician-gynecologist. 2006; 2: 44–45.7. Abrao K.C., Francisco R.P.V., Miyadahira S., Cicarelli D.D., Zugaib M. Elevation of uterine basal tone and fetal heart rate abnormalities after labor analgesia. A randomized controlled trial. Obstet. Gynecol. 2009; 113: 41–47.8. Landau R., Carvalho B., Wong C., Smiley R., Tsen L., Velde M.V.D. Elevation of uterine basal tone and fetal heart rate abnormalities after labor analgesia. A randomized controlled trial. Obstet. Gynecol. 2009; 113: 1374–1375.9. Engel N., Velde M., Nijhuis J., and Marcus M. Labor analgesia effects on fetal heart rate. A mini-review. Open J. Obstet. Gynecol. 2011; 1:113–120.10. Capogna G. Effect of epidural analgesia on the fetal heart rate. Eur. J. Obstet. Gynecol. Reproduct. Biol. 2001; 98: 160–164.11. Schifrin B.C. Fetal heart rate patterns following epidural anesthesia and oxytocin infusion during labor. J. Obstet. Gynecol. Brit. Commonnwealth. 1972; 79: 332–339.12. Savel'eva G.M., Shalina R.I., Klimenko P.A, Kurtser E.A., Karaganova E.A., Shtabnitskii A.M. Ross. vestn. akushera-ginekologa = Russian bulletin of obstetrician-gynecologist. 2003; 6: 62–68.13. Abboud T.K, David S., Nagappala S., Costandi .J, Yanagi T., Haroutunian S., Yeh S.U. Maternal, fetal and neonatal effects of lidocaine with and without epinephrine for epidural anesthesia in obstetrics. Anesthesia &Analgesia. 1984; 63: 973–979.14. Stavrou C., Hofmeyr G.J., Boezaart A.P. Prolonged fetal bradicardia during epidural analgesia. Insidence, timing and significance. South African Med. J. 1990; 77: 66–68.15. Lieberman B.A., Rosenblatt D.B. Unintended effects of epidural analgesia during labor: a systematic review. Am. J. Obstet. Gynecol. 2002; 186 (Suppl.): 31–168.16. Phillips K., Umstad M.P., Donnelly J.G., Cameron A.D., Murphy K.W. The effect of epidural bupivacaine on the fetal electrocardiogram. Australian & New Zealand J. Obstet. Gynaecol. 1996; 36: 272–274.