Advertisement

New developments in epidural anesthesia for obstetrics

      This paper is only available as a PDF. To read, Please Download here.
      Central nervous system toxicity during continuous, lumbar peridural anesthesia for obstetrics is rare in the mother and newborn if the anesthetic agent is lidocaine, lidocaine with epinephrine, or prilocaine. Mepivacaine may be associated with a higher blood level in the mother and newborn, particularly if the anesthetic is injected more than once. Prilocaine may cause methemoglobinemia in a dose greater than 600 mg. Although this condition may be reversed by the administration of methylene blue, prilocaine must be used cautiously in obstetrics. The addition of 1:200,000 epinephrine to an anesthetic retards systemic absorption of the agent and improves the quality of neural blockade. It should not be used if hypertension or tachycardia is to be avoided but probably has little effect on labor in the technique of low-dose lumbar peridural anesthesia. Difficulties in the study of the effect of anesthetics on the forces of labor are noted.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Foldes F.F.
        • Molloy R.
        • McNall P.G.
        • Koukal L.R.
        J. A. M. A. 1960; 172: 1493
        • Shnider S.M.
        • Way E.L.
        Anesthesiology. 1968; 29: 951
        • Shnider S.M.
        • Way E.L.
        Anesthesiology. 1968; 29: 944
        • Lund P.C.
        • Cwik J.C.
        Anesth. Analg. 1965; 44: 623
        • Usubiaga J.E.
        • Iuppa M.L.
        • Moya F.
        • Wikinski J.A.
        • Velazco R.
        Amer. J. Obstet. Gynec. 1968; 100: 918
        • Morishima H.O.
        • Daniel S.S.
        • Finster M.
        • Poppers P.J.
        • James L.S.
        Anesthesiology. 1966; 27: 147
        • Lund P.C.
        • Cwik J.C.
        Acta Anaesth. Scand. 1966; 23: 475
        • Moore D.C.
        • Bridenbaugh L.D.
        • Bagdi P.A.
        • Bridenbaugh P.O.
        Anesthesiology. 1968; 29: 585
        • Epstein B.S.
        • Banerjee S.G.
        • Coakley C.S.
        Anesth. Analg. 1969; 48: 592
        • Bromage P.R.
        • Robson J.G.
        Anaesthesia. 1961; 16: 461
        • Epstein B.S.
        • Banerjee S.G.
        • Coakley C.S.
        Anesth. Analg. 1968; 47: 223
        • Poppers P.J.
        • Finster M.
        Anesthesiology. 1968; 29: 1134
        • Fox G.S.
        • Houle G.L.
        Canad. Anaesth. Soc. J. 1969; 16: 135
        • Gunther R.E.
        • Harer Jr., W.B.
        Calif. Med. 1966; 105: 424
        • Thompson H.G.
        • Johnson K.R.
        • O’Connor J.J.
        Obstet. Gynec. 1967; 29: 682
        • Gunther R.E.
        • Bauman J.
        Anesthesiology. 1969; 31: 5
        • Climie C.R.
        • McLean S.
        • Starmer G.A.
        • Thomas J.
        Brit. J. Anaesth. 1967; 39: 155
        • Poppers P.J.
        • Vosburgh G.J.
        • Finster M.
        Amer. J. Obstet. Gynec. 1966; 95: 630
        • Spoerel W.E.
        • Adamson D.H.
        • Eberhard R.S.
        Canad. Anaesth. Soc. J. 1967; 14: 1
        • Marx G.F.
        Anesthesiology. 1967; 28: 222
        • Bridenbaugh P.O.
        • Bridenbaugh L.D.
        • Moore D.C.
        Anesth. Analg. 1969; 48: 824
        • Bromage P.R.
        Anesthesiology. 1967; 28: 592
        • Hehre F.W.
        Anesth. Analg. 1969; 48: 177
        • Epstein B.S.
        • Banerjee S.
        • Coakley C.S.
        Anesth. Analg. 1968; 47: 228
        • Bonica J.J.
        Principles and Practice of Obstetric Analgesia and Anesthesia. F. A. Davis Company, Philadelphia1967: 291
        • Rucker J.P.
        South. Med. J. 1925; 18: 412
        • Vasicka A.
        • Kretchmer H.
        Amer. J. Obstet. Gynec. 1961; 82: 600
      1. Bonica J.J. Clinical Anesthesia—Obstetric Complications. vol. III. F. A. Davis Company, Philadelphia1965: 117
        • Adriani J.
        • Roman-Vega D.A.
        Amer. J. Surg. 1946; 71: 12
        • Burton H.
        Brit. Med. J. 1943; 2: 389
        • Curbelo M.M.
        Anesth. Analg. 1949; 28: 13
        • Flowers C.E.
        • Hellman L.M.
        • Hingson R.A.
        Anesth. Analg. 1949; 28: 181
        • Graffagnino P.
        • Seyler L.W.
        Amer. J. Obstet. Gynec. 1938; 35: 597
        • Hellmann K.
        Canad. Anaesth. Soc. J. 1965; 12: 398
        • Hingson R.A.
        • Edwards W.B.
        Anesth. Analg. 1942; 21: 301
        • Irving F.C.
        • Berman S.
        • Nelson H.B.
        Surg. Gynec. Obstet. 1934; 58: 1
        • Simpson Sir James Y.
        Monthly J. Med. Sci. 1847; 7: 313