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Opioid effect on the autonomic nervous system in a fetal sheep model

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Opioid use during labour can interfere with cardiotocography patterns. Heart rate variability indirectly reflects a fluctuation in the autonomic nervous system and can be monitored through time and spectral analyses. This experimental study aimed to evaluate the impact of nalbuphine administration on the gasometric, cardiovascular, and autonomic nervous system responses in fetal sheep.

Methods

This was an experimental study on chronically instrumented sheep fetuses (surgery at 128 ± 2 days of gestational age, term = 145 days). The model was based on a maternal intravenous bolus injection of nalbuphine, a semisynthetic opioid used as an analgesic during delivery. Fetal gasometric parameters (pH, pO2, pCO2, and lactates), hemodynamic parameters (fetal heart rate and mean arterial pressure), and autonomic nervous system tone (short-term and long-term variation, low-frequency domain, high-frequency domain, and fetal stress index) were recorded. Data obtained at 30–60 min after nalbuphine injection were compared to those recorded at baseline.

Results

Eleven experiments were performed. Fetal heart rate, mean arterial pressure, and activities at low and high frequencies were stable after injection. Short-term variation decreased at T30 min (P = 0.02), and long-term variation decreased at T60 min (P = 0.02). Fetal stress index gradually increased and reached significance at T60 min (P = 0.02). Fetal gasometric parameters and lactate levels remained stable.

Conclusion

Maternal nalbuphine use during labour may lead to fetal heart changes that are caused by the effect of opioid on the autonomic nervous system; these fluctuations do not reflect acidosis.

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Acknowledgments

We would like to thank Editage (http://www.editage.cn) for English language editing of the manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. ULR 2694, METRICS, Evaluation des Technologies de Santé et des Pratiques Médicales, University of Lille, 59000, Lille, France

    Morgan Recher, Charles Garabedian, Estelle Aubry, Dyuti Sharma, Laura Butruille, Laurent Storme & Julien De jonckheere

  2. Department of Paediatric Intensive Care Unit, CHU Lille, Jeanne de Flandre Hospital, 59000, Lille, France

    Morgan Recher

  3. Department of Obstetrics, CHU Lille, Jeanne de Flandre Hospital, 59000, Lille, France

    Charles Garabedian

  4. Department of Pediatric Surgery, CHU Lille, Jeanne de Flandre Hospital, 59000, Lille, France

    Estelle Aubry & Dyuti Sharma

  5. Department of Neonatology, CHU Lille, Jeanne de Flandre Hospital, 59000, Lille, France

    Laurent Storme

  6. CIC-IT 1403-biosensor and e-health, CHU Lille, 59000, Lille, France

    Julien De jonckheere

  7. Jeanne de Flandre Hospital, University of Lille Nord de France, 1 rue Eugène Avinée, 59037, Lille Cedex, France

    Morgan Recher

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  1. Morgan Recher
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  2. Charles Garabedian
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  3. Estelle Aubry
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  4. Dyuti Sharma
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  5. Laura Butruille
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  7. Julien De jonckheere
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Contributions

MR: protocol/project development, data collection or management, data analysis, manuscript writing/editing. CG: protocol/project development, manuscript writing/editing. EA: protocol/project development, data collection or management. DS: protocol/project development, data collection or management. LB: data analysis. LS: protocol/project development, data analysis, manuscript writing/editing. JDJ: protocol/project development, data analysis, manuscript writing/editing.

Corresponding author

Correspondence to Morgan Recher.

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Conflict of interest

The authors do not have any conflicts of interest to disclose.

Ethics approval

All animal procedures and protocols used in this study were reviewed and approved by an Institutional Ethical Committee for Experimental Research (CEEA # 2016121312148878).

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Recher, M., Garabedian, C., Aubry, E. et al. Opioid effect on the autonomic nervous system in a fetal sheep model. Arch Gynecol Obstet 304, 73–80 (2021). https://doi.org/10.1007/s00404-020-05917-4

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  • DOI: https://doi.org/10.1007/s00404-020-05917-4

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