The Fetal and Neonatal Effects of Regional Anesthesia in Obstetrics

Ralston, David H.; Shnider, Sol M.

doi:10.1097/00000542-197801000-00007

Cited by 125 publications

(41 citation statements)

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“…It is known that a 0.25% concentration of bupivacaine blocks autonomic nerve dominantly, and transports a little amount to foetal circulation, because bupivacaine binds to protein more easily than other regional anaesthetics. [24][25][26][27] Thus it is thought that bupivacaine is relatively safe to use with pregnant women. We had no complications of neonates treated by epidural anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

A new treatment of severe pre-eclampsia by long-term epidural anaesthesia

et al. 1999

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We hypothesised that long term epidural anaesthesia suppresses sympathetic overactivity in pre-eclampsia. Two equal groups of severe pre-eclamptic patients were treated either with long-term epidural anaesthesia (epidural group) or bed rest, diet control, and an antihypertensive drug (control group). After 7 days of epidural block, mean arterial blood pressures decreased, platelet count and serum total protein increased in all cases while proteinuria decreased in four cases. All patients treated with a long-term epidural therapy continued their pregnancies for more than 3 weeks after admission. The infants in the epidural group had 1-min Apgar scores above 8, a body weight of 2240 ± 310 g (mean ± s.d.) and

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Section: Discussionmentioning

confidence: 99%

A new treatment of severe pre-eclampsia by long-term epidural anaesthesia

et al. 1999

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“…In addition, fetal acidosis causes accumulation of lidocaine in fetal blood. 7 The gastric juice in the fetus may then become more acidic because of fetal distress, so that lidocaine can cross the fetal lipid gastric barrier and dissociate according to the gastric pH. Gastric fluid lidocaine concentrations have been reported to be higher than fetal serum concentrations.…”

Section: Discussionmentioning

confidence: 99%

Placental transfer of lidocaine hydrochloride after prolonged continuous maternal intravenous administration

et al. 1995

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We treated a patient with arrhythmia during pregnancy with prolonged intravenous administration of lidocaine hydrochloride. This was a case of twin-to-twin transfusionLidocaine is widely used for maternal analgesia during labour and sometimes for the treatment of arrhythmia in pregnant women. There are many reports of human placental lidocaine transfer after brief administration following maternal epidural, spinal, caudal, paracervical or pudendal analgesia during labour. However, for continuous maternal lidoeaine infusion, several studies have been reported but only in animals, t-3 There are no reports on the effects in humans of continuous maternal intravenous lidoeaine administration on fetal serum and amniotic fluid (AF) lidocaine concentrations. Since it is possible for excessive fetal serum and AF lidocaine concentrations to be produced in humans, we submit this report on a patient who received intravenous administration of lidocaine hydrochlofide for 12 days to treat arrhythmia during pregnancy. Maternal serum, fetal serum and AF lidocaine concentrations were measured at the time of delivery. Case reportA 30-yr-old woman was referred at 23 wk gestation because of preterm labour and polyhydramnios. She was CAN J ANAESTH 1995 / 42:4 / pp 338-40

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“…The concentrations of local anaesthetics used in this study were slightly higher than maternal plasma concentrations measured following administration of local anaesthetics for labour or Caesarean section (Ralston & Shnider, 1978). Rapid in vivo hydrolysis of 2-chloroprocaine reduces absorbed concentrations to nanogram levels.…”

Section: Kci-induced Contractionmentioning

confidence: 62%

“…Local anaesthetic toxicity has been reported in parturients who received regional anaesthesia and, in addition, placental transfer of these agents has been confirmed by the presence of measurable quantities in umbilical cord blood (Ralston & Shnider, 1978). Foetal and neonatal well-being has been evaluated from foetal heart rate tracings, neonatal Apgar scores, and neurobehavioural scores; and results have been compared in the presence or absence of regional anaesthesia (Ralston & Shnider, 1978). However, the direct action of local anaesthetics on the vascular smooth muscle of the umbilical cord has not been extensively studied, although this tissue is an essential component in the regulation of the umbilical-placental circulation.…”

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confidence: 95%

“…Foetal effects of maternal local anaesthetic administration have been under intense scrutiny for the past few years. Local anaesthetic toxicity has been reported in parturients who received regional anaesthesia and, in addition, placental transfer of these agents has been confirmed by the presence of measurable quantities in umbilical cord blood (Ralston & Shnider, 1978). Foetal and neonatal well-being has been evaluated from foetal heart rate tracings, neonatal Apgar scores, and neurobehavioural scores; and results have been compared in the presence or absence of regional anaesthesia (Ralston & Shnider, 1978).…”

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confidence: 99%

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Vasoactive actions of local anaesthetics on human isolated umbilical veins and arteries

Monuszko

Halevy

Freese

et al. 1989

British J Pharmacology

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1 An in vitro study, using helical preparations of human umbilical arteries and veins obtained from healthy women at term pregnancy, was designed to determine: (a) whether three local anaesthetics commonly utilized in obstetric anaesthesia (bupivacaine, 2-chloroprocaine, and lignocaine) can induce contraction or relaxation of resting umbilical vessels; (b) whether these agents can induce contraction or relaxation of umbilical vessels which have been previously induced to contract by a known activator, potassium chloride (KCI); and (c) the relative potency of these agents as compared to KC1. 2 The results indicate that: (a) these local anaesthetics are vasoactive on human umbilical vascular smooth muscle; (b) bupivacaine induces contraction in over 90% of the resting vessels examined, while 2-chloroprocaine consistently causes relaxation and lignocaine causes a small degree of contraction in 40% of vessels examined; (c) bupivacaine causes further contraction (or potentiation) of KC1-contracted muscle in 50% of the vessels studied, while 2-chloroprocaine and lignocaine both induce relaxation of these contracted vessels.Introducion

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The Fetal and Neonatal Effects of Regional Anesthesia in Obstetrics

Cited by 125 publications

References 0 publications

A new treatment of severe pre-eclampsia by long-term epidural anaesthesia

A new treatment of severe pre-eclampsia by long-term epidural anaesthesia

Placental transfer of lidocaine hydrochloride after prolonged continuous maternal intravenous administration

Vasoactive actions of local anaesthetics on human isolated umbilical veins and arteries

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