Fetal Acid‐base Balance and Heart Rate Duringlabour With Bupivacaine Paracervical Block Anaesthesia

Maternal and fetal effects of low-dosage bupivacaine paracervical block

“…Similar finding was also reported by MEIS [12]. The fetal pH did not decrease on average after j PCB but the fall was more pronounced in 3 cases with bradycardia which is in accordance with the findings of previous studies [16]. No universal change in the mean uterine activity was noticed after PCB, but in five cases demonstrating bradycardia three showed a prompt increase in uterine contractions and in the baseline tone, which might at least partly explain the change in the FHR pattern.…”

“…bradycardia are not unambiguous. Late decelerations in our study were observed in five cases after PCB and mostly in association with bradycardia as also noted in earlier reports [16]. Decreased FHR variability (silent pattern) was > observed after 20% of the blocks which corre-|j sponds to the findings of MEIS et al [12].…”

“…Bradycardia lasting on average for 8 minutes and starting 2-4 minutes after PCB was observed at a 12% rate. TERAMO [16], by using 100mg or 50 mg of bupivacaine, found a 21 % frequency of bradycardia, HOLLMEN [6] a rate of 30%, JÄGERHORN [10] a 10% rate but MEIS [12] and REID [14] almost none. Comparison of FHR patterns after PCB are difficult because most earlier studies have not been done with direct FHR recording and also the criteria of pathological and non-pathological FHR patterns, e.g.…”

Vasoactive actions of local anaesthetics on human isolated umbilical veins and arteries

“…Although favourable foetal outcome as assessed by Apgar scores, acid-base status, and neurobehavioural scores following regional anaesthesia with bupivacaine has been obtained (Scanlon et al, 1976;Abboud et al, 1983a;Kileff et al, 1984), questions have been raised concerning its safety in uncomplicated regional anaesthesia. Data have shown a significantly increased incidence of foetal bradycardia following epidural anaesthesia with bupivacaine as compared to epidural anaesthesia with lignocaine or 2-chloroprocaine; and following paracervical block with bupivacaine (Teramo, 1969;Abboud et al, 1982). There are accounts of bupivacaine-induced maternal central nervous system and cardiovascular toxicity, with the latter accounting for cases of refractory cardiovascular collapse.…”

Intramuscular pethidine (meperidine) during labor associated with metabolic acidosis in the newborn

“…An ant tum anal is PCB [6], but less frequently with smaller doses f FH^ variabilit at gestational weeks 36 to and more superficial application [4]. The pre-3g wa § formed y for ^ fetuses [3] .…”