Pharmacokinetics of Lidocaine in Fetal and Neonatal Lambs and Adult Sheep

Morishima, Hisayo O.; Finster, Mieczyslaw; Pedersen, H.; Fukunaga, A. F.; Ronfeld, Robert A.; Vassallo, Helen; Covino, Benjamín G.

doi:10.1097/00000542-197905000-00011

Cited by 46 publications

(23 citation statements)

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“…2 and 3, respectively. Based on our previous studies, the baseline values were within the normal range for sheep [12,13]. Maternal respiration became progressively more depressed when the inhaled concentration of either sevofl urane or isofl urane increased beyond 1.0 MAC.…”

Section: Ph and Blood Gasesmentioning

confidence: 55%

Comparison of the effects of sevoflurane and isoflurane anesthesia on the maternal-fetal unit in sheep

et al. 2009

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Section: Ph and Blood Gasesmentioning

confidence: 55%

Comparison of the effects of sevoflurane and isoflurane anesthesia on the maternal-fetal unit in sheep

et al. 2009

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“…Surgery was pcrformed und er spinal anesthesia with tetracaine, supplemented as necessary with in travenous administration of thiopental. The details of the surgery have been described elsewhere (8). For the purpose of monitoring and sampling, catheters were implantcd in the femoral artery and vein of the mother and in the carotid artery and jugular vein of thc fetus, and also into the amniotic cavity.…”

Section: Methodsmentioning

confidence: 99%

The Effect of Diazepam on Maternal and Fetal Stress Responses in the Sheep

Morishima¹,

Sakuma²,

Bruce³

et al. 1980

Dev Pharmacol Ther

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“…This concentration gradient either suggests continued fetal tissue uptake or metabolism by the fetus. The second explanation appears reasonable because the neonate was shown to efficiently eliminate lidocaine (with half-lives comparable to those observed in the mother) [Kuhnert et al, 1979;Morishima et al, 1979]. Also the presence of metabolites in the neonate's urine shortly after birth indi rectly implied fetal metabolism of lidocaine [Blankenbaker et ah, 1975].…”

Section: Transfer To the Fetusmentioning

confidence: 99%

Clinical Pharmacokinetics in Pregnancy and Perinatology

Nau¹

1985

Dev Pharmacol Ther

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Local anaesthetic agents, both of the amide type (e.g., lidocaine, bupivacaine, etidocaine) and of the ester type (e.g., 2-chloroprocaine) are widely used to relieve pain in obstetric and gynaecological practice. The pharmacokinetics of these compounds are discussed in this review, with particular emphasis on the fetal exposure and its relationship to adverse effects on the fetus. 2-Chloroprocaine is rapidly hydrolyzed by esterases, and only traces of this compound reach the fetus, even following multiple injections, suggesting safety for the fetus. The main disadvantage of this compound is the short duration of action (0.5-1 h). The amide-type agents are active for longer time periods (up to several hours). The fetal/matemal total concentration ratios were approximately 0.3 for bupivacaine and etidocaine, 0.5 for lidocaine, 0.7 for mepivacaine, and 1 for prilocaine. The low ratios of bupivacaine and etidocaine result from extensive binding (90%) of these drugs to maternal a(1)-acid glycoprotein which exceeds corresponding fetal protein binding (50%). These low fetal/matemal total concentration ratios cannot be equated with fetal safety, because fetal side effects are better related to the free drug levels. Since the amide- type anaesthetics are weak bases, fetal acidosis will increase the matemal/fetal pH gradient and will result in accumulation of free drug in the fetus and possible fetal side effects. Addition of epinephrine to the injection solution reduces the maternal blood levels of the amide-type compounds, but apparently not the fetal levels to the same extent. Because of possible unwanted effects of epinephrine (decreased uterine blood flow), the addition of this compound is not generally accepted to be of advantage. Paracervical blockade may result in elevated fetal blood levels (possibly by transarterial diffusion into uterine arteries) and possibly fetal bradycardia.

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Pharmacokinetics of Lidocaine in Fetal and Neonatal Lambs and Adult Sheep

Cited by 46 publications

References 0 publications

Comparison of the effects of sevoflurane and isoflurane anesthesia on the maternal-fetal unit in sheep

Comparison of the effects of sevoflurane and isoflurane anesthesia on the maternal-fetal unit in sheep

The Effect of Diazepam on Maternal and Fetal Stress Responses in the Sheep

Clinical Pharmacokinetics in Pregnancy and Perinatology

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