Epidural anesthesia for cesarean section: a comparison of bupivacaine, chloroprocaine, and etidocaine.
The authors studied three groups of patients undergoing elective cesarean section during lumbar epidural anesthesia with bupivacaine, 0.75 per cent (15 patients), chloroprocaine, 3 per cent (15 patients) or etidocaine, 1 per cent (ten patients). Excellent sensory and motor block were obtained with chloroprocaine and bupivacaine; sensory anesthesia was inadequate with etidocaine in most patients. Onset of anesthesia, induction--delivery interval, and stay in the recovery room were all longer with bupivacaine when compared with chloroprocaine. Fetal outcomes, as determined by Apgar scores, acid--base status and neurobehavioral testing, were equally good in all groups. At delivery, fetal/maternal concentration ratio of bupivacaine was 0.31 and that of etidocaine, 0.25. The umbilical artery--umbilical vein blood concentration difference for etidocaine was significantly higher than that for bupivacaine. Excellent clinical results were obtained using either bupivacaine, 0.75 per cent, alone, or chloroprocaine, 3 per cent- for induction and maintenance of anesthesia, supplemented with bupivacaine, 0.25 per cent, before removal of the catheter.
D000083:Acetanilides; D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D001034:Apgar Score; D002045:Bupivacaine / Q000097:blood; D002585:Cesarean Section; D005041:Etidocaine / Q000008:administration & dosage / Q000097:blood; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D011247:Pregnancy; D011343:Procaine / Q000031:analogs & derivatives* / Q000097:blood
D000083:Acetanilides; D011343:Procaine; C004616:chloroprocaine; D005041:Etidocaine; D002045:Bupivacaine