Analgesics and anaesthetics during peripartum period

Our focus in KuBiCo–project is to evaluate the foetal and newborn effects of analgesics and anaesthetics given for parturient during peripartum period. Maternal pharmacokinetics and –dynamics of different compounds used for pain relief and anaesthesia for caesarean section will be measured. Foetal and newborn exposure will be estimated based on the drug concentrations in the placental venous and arterial blood. Pharmodynamic effects of these compounds on newborn will be tested with a comprehensive neurological and adaptive capacity evaluation, and by recording amplitude integrated EEG. All these measures are painless for newborn.

Group leader, Hannu Kokki, Professor in Anaesthesiology
University of Eastern Finland,
School of Medicine
email: hannu.kokki@uef.fi
tel: +358 50 379 0374

Publications:

• Kokki M, Franco MG, Raatikainen K, Välitalo P, Sankilampi U, Heinonen S, Neuvonen PJ, Kokki H. Intravenous oxycodone for pain relief in the first stage of labour--maternal pharmacokinetics and neonatal exposure. Basic Clin Pharmacol Toxicol. 2012 Sep;111(3):182-8.
• Kokki M, Sjövall S, Keinänen M, Kokki H. The influence of timing on the effectiveness of epidural blood patches in parturients. Int J Obstet Anesth. 2013 Nov;22(4):303-9.
• Kokki M, Välitalo P, Kuusisto M, Ranta VP, Raatikainen K, Hautajärvi H, Kokki H. Central nervous system penetration of oxycodone after intravenous and epidural administration. Br J Anaesth. 2014 Jan;112(1):133-40.
• Räisänen S, Kokki M, Kokki H, Gissler M, Kramer MR, Heinonen S. The use of epidural analgesia for intrapartum pain relief in publicly funded healthcare. Acta Anaesthesiol Scand. 2014 Mar;58(3):291-7
• Heikkinen EM, Voipio HM, Laaksonen S, Haapala L, Räsänen J, Acharya G, Erkinaro T, Haapsamo M, Hautajärvi H, Kokki H, Kokki M, Heikkinen AT. Fentanyl pharmacokinetics in pregnant sheep after intravenous and transdermal administration to the ewe. Basic Clin Pharmacol Toxicol. 2015 Sep;117(3):156-63.
• Kokki M, Heikkinen AT, Raatikainen K, Ranta VP, Hautajärvi H, Kokki H. Pharmacokinetics of intranasal fentanyl in parturient. Br J Anaesth. 2015 Oct;115(4):635-6.
• Kokki M, Westeren-Punnonen S, Hautajärvi H, Heinonen S, Mazzei M, Määttä S, Paalanen E, Kokki H. Neonatal safety of maternal fentanyl during labour. Br J Anaesth. 2015 Oct;115(4):636-8.
• Kokki M, Pesonen M, Vehviläinen P, Litmala O, Pasanen M, Kokki H. Cytotoxicity of oxycodone and morphine in human neuroblastoma and mouse motoneuronal cells: A comparative approach. Drugs R D. 2016 Jun;16(2):155-63.
• Heikkinen EM, Kokki H, Heikkinen A, Ranta VP, Räsänen J, Voipio HM, Kokki M. Foetal fentanyl exposure and ion trapping after intravenous and transdermal administration to the ewe. Basic Clin Pharmacol Toxicol. 2017 Feb;120(2):195-198.
• Kokki M, Heikkinen M, Välitalo P, Hautajärvi H, Hokkanen J, Pitkänen H, Sankilampi U, Ranta VP, Kokki H. Maturation of oxycodone pharmacokinetics in neonates and infants: Oxycodone and its metabolites in plasma and urine. Br J Clin Pharmacol. 2017 Apr;83(4):791-800.
• Välitalo P, Kokki M, Ranta VP, Olkkola KT, Hooker AC, Kokki H. Maturation of oxycodone pharmacokinetics in neonates and infants: a population pharmacokinetic model of three clinical trials. Pharm Res. 2017 May;34(5):1125-1133.
• Kinnunen M, Kokki H, Hautajärvi H, Huhta H, Ranta VP, Räsänen J, Voipio HM, Kokki M. Oxycodone pharmacokinetics and fetal exposure after intravenous or epidural administration to the ewe. Acta Obstet Gynecol Scand. 2018 May 17. doi: 10.1111/aogs.13378. [Epub ahead of print]
• Tujula B, Kokki H, Räsänen J, Kokki M. Procalcitonin; a feasible biomarker for severe bacterial infections in Obstetrics and Gynecology? Acta Obstet Gynecol Scand. 2018 May;97(5):505-506. doi: 10.1111/aogs.13346.