Placental transfer of lidocaine following paracervical block.

Abstract Following a standardized paracervical block (PCB), serial fetal and maternal blood concentrations of lidocaine were determined in 10 patients. The mean maternal and fetal lidocaine concentrations reached maximum values between 9 and 10 minutes. Post-PCB fetal bradycardia was encountered, once associated with elevated fetal lidocaine concentrations and once associated with low or normal concentrations. Post-PCB fetal bradycardia was not seen in the one instance when fetal lidocaine concentration exceeded the concomitant maternal concentration. Fetal acidosis was seen in one case of post-PCB fetal bradycardia. Apgar scores were uniformly good at 5 minutes. Preliminary studies indicate that the lidocaine metabolite (monoethylglycinexylidide)/lidocaine ratio is greater in the fetus than in the mother.

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