The Risks of Paracervical Anesthesia: Intoxication and Neurological Injury of the Newborn

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Abstract
Paracervical block is a very popular method of relieving obstetric pain during the first stage of labor. The intoxication of a newborn by mepivacaine anesthesia and his survival and neurological abnormalities at 4 11/12 yr are described. In addition to a discussion of this case, clinical signs reported in infants with apparent mepivacaine toxicity are listed. Direct drug toxicity may share a role with drug-induced intrauterine hypoxia as a cause of depression. There is no clear evidence favoring either. Thoughtful reconsideration of local anesthetic risk by the obstetrician is warranted. Toxicity may be unperceived and the outcome of neurological abnormality may not be viewed in light of the agent''s usage.