Bupivacaine Disposition in Mother, Fetus, and Neonate after Spinal Anesthesia for Cesarean Section
- 1 May 1987
- journal article
- research article
- Published by Wolters Kluwer Health in Anesthesia & Analgesia
- Vol. 66 (5) , 407-412
- https://doi.org/10.1213/00000539-198705000-00006
Abstract
Uptake of bupivacaine from the subarachnoid space and its placental transfer were measured in six patients undergoing elective cesarean section. Maternal plasma levels (59 .+-. 32 ng/ml) were only about 5% of those found in a comparable previous study of epidural anesthesia. Mean plasma umbilical venous bupivacaine levels (20.2 .+-. 21 ng/ml) were 7% of those found after epidural anesthesia. Mean umbilical venous/maternal venous bupivacaine ratios were 0.34 .+-. 0.12 and mean umbilical arterial/umbilical venous ratios were 0.81 .+-. 0.30. No bupivacaine was detectable in neonatal plasma 24 hr after delivery. Neonatal urine had measurable levels of both bupivacaine and its inactive metabolite, 2,6-pipecolylxylidine (PPX), for at least 36 hr after delivery. The results demonstrate that bupivacaine crosses the placenta and reaches the fetus, but in very low amounts. This transplacental passage occurs despite injection of only small doses of a very highly protein bound drug into the subarachnoid space.This publication has 3 references indexed in Scilit:
- Hyperbaric Bupivacaine for Spinal Anesthesia in Cesarean SectionAnesthesia & Analgesia, 1984
- PLASMA-CONCENTRATIONS OF LIDOCAINE AND BUPIVACAINE AFTER SUBARACHNOID ADMINISTRATION1983
- The Use of a Selected Ion Monitoring Technique to Study the Disposition of Bupivacaine in Mother, Fetus, and Neonate Following Epidural Anesthesia for Cesarean SectionAnesthesiology, 1981