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Effects of bupivacaine and calcium antagonists on human uterine arteries in pregnant and non‐pregnant women
Author(s) -
Norén H.,
Lindblom B.,
Källfelt B.
Publication year - 1991
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1991.tb03334.x
Subject(s) - medicine , bupivacaine , verapamil , nifedipine , bradycardia , anesthesia , vasoconstriction , fetus , local anesthetic , blockade , gestational age , calcium , gestation , pregnancy , blood pressure , heart rate , receptor , biology , genetics
Bupivacaine is a local anesthetic commonly used in obstetrical practice. Although not generally constrictive, it has a constricting effect on blood vessels in clinically used doses, and when administered close to the uterine vasculature, as in a paracervical blockade, it can induce severe fetal bradycardia and thus be hazardous to the fetus. The bupivacaine‐induced vasoconstriction on uterine arteries from pregnant and non‐pregnant women was effectively reduced by two different calcium antagonists, verapamil and nifedipine. In non‐pregnant women, nifedipine (2.9 times 10 ‐2 mol·l ‐1 ) administered simultaneously with bupivacaine (5.8 times 10 ‐1 mol·l ‐1 ) caused a 96% and verapamil (10 ‐5 mol·l ‐1 ) an 84% reduction as compared with the control vessel where only bupivacaine (5.8 times 10 ‐4 mol·l ‐1 ) was administered. In pregnant women, nifedipine 2.9 times 10 ‐1 mol·I ‐1 and 2.9 times 10 ‐6 mol·l ‐1 produced 66% and 79% reductions, respectively. It is possible that calcium antagonists administered together with bupivacaine in paracervical blockade could reduce the risk of fetal bradycardia.