Open AccessLocal Anesthetic Agents???Pharmacologic Basis for Use in Obstetrics
Author(s) -
Larry Salts,
Maryann Ott,
Philip D. Walson
Publication year - 1976
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/00000539-197611000-00018
Subject(s) - medicine , paracervical block , anesthesia , local anesthetic , bupivacaine , anesthetic , fetus , fetal distress , lumbar , epidural block , obstetrics , pregnancy , surgery , lidocaine , biology , genetics
Because of the minimal effects on mother and fetus, regional anesthetic technics are widely employed for labor and delivery. However, the literature describes at least 35 fetal and neonatal deaths and a frightening incidence of fetal distress associated with paracervical block for 1st-stage labor. Continuous lumbar epidural anesthesia for 1st-stage labor has also been associated with fetal distress, but this is minimal and no deaths have been reported. Bupivacaine, a relatively new, long-lasting local anesthetic, is extemely toxic when administered paracervically, but no deaths have been reported with its use for epidural anesthesia. While choice of method and agent must be individualized, continuous lumbar epidural block with bupivacaine appears as effective as and less often dangerous to the fetus than paracervical block.