Intrapartum paracervical block anesthesia with 2-chloroprocaine
| Autor: | Betty R. Kuhnert, Carol B. Syracuse, Mortimer G. Rosen, Elliot H. Philipson, Anne L. P. Reese |
|---|---|
| Rok vydání: | 1983 |
| Předmět: |
Adult
Lidocaine Adolescent medicine.drug_class Mepivacaine Urine Pregnancy Paracervical block Medicine Anesthesia Obstetrical Humans Anesthetics Local Adverse effect Fetal Monitoring Maternal-Fetal Exchange gamma-Aminobutyric Acid Acidosis business.industry Local anesthetic Infant Newborn Obstetrics and Gynecology Fetal Bradycardia Kinetics Anesthesia Drug Evaluation Female medicine.symptom business Labor Stage First Procaine medicine.drug |
| Zdroj: | American journal of obstetrics and gynecology. 146(1) |
| ISSN: | 0002-9378 |
| Popis: | Most of the reports of fetal bradycardia and acidosis following paracervical block anesthesia have involved the use of amide-linked anesthetics, such as lidocaine and mepivacaine. The purposes of this study were (1) to determine placental transfer of an ester-linked local anesthetic, 2-chloroprocaine, and its inactive metabolite, 2-chloroaminobenzoic acid (CABA) following paracervical block and (2) to evaluate the clinical use of 2-chloroprocaine for paracervical block anesthesia. Accordingly, 2-chloroprocaine was administered to 16 normal pregnant women in labor at term. Following injection, the levels of 2-chloroprocaine or CABA in maternal and neonatal plasma or urine were quantitated. Multiple clinical parameters, including the presence or absence of fetal bradycardia, were monitored before and after the paracervical block. The pharmacologic data indicated that 2-chloroprocaine is rapidly hydrolyzed. At delivery only trace levels of 2-chloroprocaine were present in 6.3% of the maternal samples and 25% of the cord vein samples. Furthermore, only 0.24% of the total dose of 2-chloroprocaine administered was recovered in neonatal urine as CABA. The clinical data showed no adverse effects on the parturient or neonate. Therefore, the data suggest that paracervical block anesthesia with 2-chloroprocaine may offer safe analgesia during the first stage of labor. Larger clinical studies appear warranted. |
| Databáze: | OpenAIRE |
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