Effect of Lidocaine on the Asphyxial Responses in the Mature Fetal Lamb

Morishima, Hisayo O.; Santos, Alan C.; Pedersen, H.; Finster, Mieczyslaw; Tsuji, Akiko; Hiraoka, Hitoshi; Arthur, G. R.; Covino, Benjamín G.

doi:10.1097/00000542-198704000-00009

Cited by 18 publications

(4 citation statements)

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“…Conversely, there is some evidence that even clinically encountered concentrations of local anesthetic may adversely affect blood flow distribution within the asphyxiated fetus. 26 In preterm pregnant ewes, lidocaine interfered with the normal compensatory shunting of blood flow to the heart, brain, and adrenal glands during asphyxia. This effect was less pronounced in term fetuses or when bupivacaine was administered.…”

Section: Adverse Effects On the Fetusmentioning

confidence: 99%

Local Anesthetic Pharmacology

Datta

Kodali

Segal

2009

Obstetric Anesthesia Handbook

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Section: Adverse Effects On the Fetusmentioning

confidence: 99%

Local Anesthetic Pharmacology

Datta

Kodali

Segal

2009

Obstetric Anesthesia Handbook

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“…However, the physiologic func tion of cholinesterases is poorly understood. Table 3 demonstrates the comparison of placental transfer of cocaine [20], lidocaine [28], and bupivacaine [29] obtained from our pre viously published data in chronically catheterized sheep. The drug was infused intrave nously until both maternal and fetal drug con centrations reached a steady state and mater nal and fetal arterial blood samples were with drawn simultaneously.…”

Section: Hemodynamic Response To Cocaine In Pregnant Ratsmentioning

confidence: 99%

Pregnancy Alters the Hemodynamic Responses to Cocaine in the Rat

Morishima¹,

Cooper²,

Hara³

et al. 1992

Dev Pharmacol Ther

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To test our hypotheses that the hemodynamic response to cocaine may be altered during pregnancy, cocaine (0.33 mg/kg/min) was infused intravenously to chronically catheterized pregnant and nonpregnant female rats. Cardiac output and regional blood flow were measured, and cocaine concentrations in plasma and tissues, as well as plasma cholinesterase activity were determined. Results were compared between pregnant and nonpregnant groups. Cocaine produced a significant decrease in heart rate, accompanied by a fall in cardiac output, and decreased cerebral, myocardial, and placental blood flow in pregnant rats. The plasma cocaine concentration in pregnant animals was lower than that of nonpregnant ones, but tissue concentrations were similar in both groups. These results indicate that pregnancy enhances cardiovascular responses to subtoxic doses of cocaine. There was little placental transfer of cocaine with a fetal to maternal plasma concentration ratio of 0.28.

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“…Another factor to consider are gestational changes in maternal drug binding to serum albumin and alphal-acid glycoprotein which tends to decrease. Serial determinations of protein binding of diazepam, phenytoin and valproic acid in the maternal serum carried out in early (8)(9)(10)(11)(12)(13)(14)(15)(16) weeks), mid (17-32 weeks), and late pregnancy showed a progressive increase in the unbound fraction of these drugs (4). That would increase drug availability for placental transfer, putting the term fetus at a disadvantage by comparison with the preterm one.…”

mentioning

confidence: 99%

“…Asphyxia results in a redistribution of fetal cardiac output which increases oxygen delivery to the vital organs, such as the brain, heart and adrenals. Studies in chronically instrumented pregnant ewes have shown that this circulatory adaptation to asphyxia is not altered in the term fetus by moderate plasma concentrations of lidocaine (9). In contrast, the preterm fetus, exposed to similar plasma concentrations of the drug, loses its cardiovascular adaptation to asphyxia, and its condition deteriorates(l0).…”

mentioning

confidence: 99%