Epidural Anesthesia for Cesarean Section in Diabetic Parturients

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Abstract
Acid-base status and blood levels of bupivacaine were determined in 16 diabetic parturients and their infants after epidural anesthesia for cesarean section. The newborn infants were divided into two groups based on umbilical artery pH at birth. Group A consisted of 10 infants who had a pH of >7.2 and group B consisted of six infants with a pH of <7.2. Neonatal acidosis was related to both the severity of maternal diabetes and the presence of maternal hypotension after epidural anesthesia. In addition, the half-life of bupivacaine was prolonged in acidotic infants. The placental transfer of bupivacaine, as judged by umbilical vein/maternal vein ratios, was significantly greater in acidotic infants.

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