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Anesth Analg 1983; 62:914-919
© 1983 International Anesthesia Research Society
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Epidural Bupivacaine, Chloroprocaine, or Lidocaine for Cesarean Section-Maternal and Neonatal Effects

Therese K. Abboud, MD, Kyung Chul Kim, MD, Rabia Noueihed, MD, Betty R. Kuhnert, MD, Nooshik DerMardirossian, MD, Jean Moumdjian, MD, Faruk Sarkis, MD, and Shakuntala Nagappala, MD

Received from the Department of Anesthesiology, Women's Hospital, Los Angeles County-University of Southern California Medical Center, Los Angeles, California; and the Departments of Obstetrics and Gynecology and Reproductive Biology, Cleveland Metropolitan General Hospital, Cleveland, Ohio.

Abstract

The effects of epidural anesthesia on maternal blood pressure, newborn Apgar scores, neonatal acid–base status, and the early neonatal neurobehavioral scale (ENNS) were studied in 54 pregnant women undergoing cesarean section. Maternal and neonatal blood levels of the local anesthetics were also determined. Group 1 (n = 16) received 0.75% bupivacaine, group 2(n = 18) received 3% chloroprocaine, group 3 (n = 11) received 2% lidocaine, and group 4 (n = 9) received 2% lidocaine with 1:200,000 epinephrine. The incidence of maternal hypotension did not differ significantly among the four groups. Fetal outcome as determined by Apgar scores, acid–base status, and neurobehavioral testing was equally good in all four groups. At delivery, the fetal/maternal concentration ratio of bupivacaine was 0.27, that of lidocaine without epinephrine 0.48, and that of lidocaine with epinephrine 0.58. Chloroprocaine was detected in 12 maternal samples, in seven umbilical venous samples, and in six umbilical arterial samples. It is concluded that epidural anesthesia as administered in this study had no adverse effect on the newborn Apgar scores, cord acid–base status, or the ENNS.

Key Words: ANESTHETICS, Local: bupivacaine, lidocaine, chloroprocaine • ANESTHESIA: obstetric




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1983 by the International Anesthesia Research Society.