Neonatal Neurobehavioral Responses after Epidural Anesthesia for Cesarean Section Using Lidocaine and Bupivacaine

We compared the early neonatal neurobehavioral responses after lumbar epidural anesthesia for elective cesarean section using 2% lidocaine (n = 10) and 0.5% bupivacaine (n = 21). We tested the infants at 4 and 24 hr after birth and found that the neonates in the lidocaine group scored as well as those in the bupivacaine group on all parameters of the early neonatal neurobehavioral score (ENNS). In fact on one parameter, sucking response at 24 hr, the neonates in the lidocaine group scored significantly higher than those in the bupivacaine group. We concluded that 2% lidocaine does not compromise newborn outcome when compared to 0.5% bupivacaine and that it provides a satisfactory choice for use during elective cesarean section in healthy pregnancies. This conclusion is important in the light of the current concern over the safety of the use of chloroprocaine and bupivacaine in obstetric anesthesia.

[1]  F. Reynolds Neonatal neurobehavioral responses after epidural anesthesia for cesarean section using lidocaine and bupivacaine. , 1984, Anesthesia and analgesia.

[2]  R. Knapp Bupivacaine cardiotoxicity may be more related to technique than to the drug. , 1984, Anesthesiology.

[3]  B. R. Kuhnert,et al.  Epidural Bupivacaine, Chloroprocaine, or Lidocaine for Cesarean Section‐Maternal and Neonatal Effects , 1983, Anesthesia and analgesia.

[4]  T. Abboud,et al.  Lack of Adverse Neonatal Neurobehavioral Effects of Lidocaine , 1983, Anesthesia and analgesia.

[5]  T. Abboud,et al.  Maternal, Fetal, and Neonatal Responses after Epidural Anesthesia with Bupivacaine, 2‐Chloroprocaine, or Lidocaine , 1982, Anesthesia and analgesia.

[6]  L. S. Reisner,et al.  Persistent neurologic deficit and adhesive arachnoiditis following intrathecal 2-chloroprocaine injection. , 1980, Anesthesia and analgesia.

[7]  S. Datta,et al.  Epidural Anesthesia for Cesarean Section: A Comparison of Bupivacaine, Chloroprocaine, and Etidocaine , 1981 .

[8]  G A Albright,et al.  Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. , 1979, Anesthesiology.

[9]  G. Tucker,et al.  Clinical Pharmacokinetics of Local Anaesthetics , 1979, Clinical pharmacokinetics.

[10]  G. McGuinness,et al.  Epidural Anesthesia with Bupivacaine for Cesarean Section: Neonatal Blood Levels and Neurobehavioral Responses , 1978, Anesthesiology.

[11]  J. Scanlon,et al.  Neurobehavioral Responses and Drug Concentrations in Newborns after Maternal Epidural Anesthesia with Bupivacaine , 1976, Anesthesiology.

[12]  J. Scanlon,et al.  Neurobehavioral Responses of Newborn Infants after Maternal Epidural Anesthesia , 1974, Anesthesiology.

[13]  A. Korner,et al.  Sex differences in newborns with special reference to differences in the organization of oral behavior. , 1973, Journal of child psychology and psychiatry, and allied disciplines.