title: [Fetal methemoglobinemia caused by prilocaine--is use of prilocaine for pudendal block still justified?].
abstract: 17 women received 2 x 10 ml prilocaine 1% as a pudendal block sub partu. At delivery, the foetomaternal distribution ratio of the local anaesthetic was evaluated and the development of Met-Hb-concentration in the neonate was measured up to six hours post partum. The Met-Hb-concentration in the neonate was relatively low with a maximum of 1.8% after two hours, followed by a steady decline. A probable explanation for the Met-Hb-concentration could be the unexpected low foetomaternal ratio of distribution (0.5) and the increased renal elimination of the amide-type local anaesthetic in the neonate, respectively. According to these results, no contraindication for prilocaine in pudendal block is indicated.
authors.affiliation: Zentrum für Frauenheilkunde und Geburtshilfe, Justus-Liebig-Universität Giessen.
authors.forename: M
authors.initials: M
authors.lastname: Kirschbaum
authors.forename: J
authors.initials: J
authors.lastname: Biscoping
authors.forename: B
authors.initials: B
authors.lastname: Bachmann
authors.forename: W
authors.initials: W
authors.lastname: Künzel
mesh_terms: D000282:Administration, Intravaginal; D000772:Anesthesia, Local; D000773:Anesthesia, Obstetrical; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange / Q000187:drug effects / Q000502:physiology; D008657:Metabolic Clearance Rate; D008706:Methemoglobin / Q000378:metabolism; D008708:Methemoglobinemia / Q000097:blood / Q000139:chemically induced*; D011247:Pregnancy; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics
chemical_list: D011318:Prilocaine; D008706:Methemoglobin
vernacular_title: Fetale Met-Hämoglobinämie durch Prilocain--Ist der Einsatz von Prilocain zur Pudendusblockade noch gerechtfertigt?