METHAEMOGLOBINAEMIA IN MOTHER AND FOETUS FOLLOWING CONTINUOUS EPIDURAL ANALGESIA WITH PRILOCAINE

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Abstract
The methaemoglobinaemia induced by prilocaine administered as a continuous epidural analgesic to women in labour has been examined. At delivery the level of methaemoglobin present in both the maternal and foetal blood was found to be similar in most of the ten cases examined. The decline in methaemoglobinaemia after birth of two infants born with high methaemoglobin levels (14.2 and 16 per cent) was examined. In both cases the level fell to very low values within 24 hours (2 and 3.7 per cent respectively). A parallel study was carried out on cats in labour when it was found that administration of prilocaine to the mother produced virtually no methaemoglobin in the foetus, illustrating the species difference of this response. Cats were chosen because they are particularly sensitive to the methaemoglobin formation induced by aromatic amines and amides.

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