Schürg R, Biscoping J, Bachmann B, Jovanovic V, Hohmann M, Hempelmann G
Abteilung Anästhesiologie und Operative Intensivmedizin, Klinikum der Justus-Liebig Universität Giessen.
Geburtshilfe Frauenheilkd. 1989 Nov;49(11):952-7. doi: 10.1055/s-2008-1036116.
Peripheral venous blood samples were drawn for bupivacaine analyses (gas chromatography) from 24 patients under epidural anaesthesia, used to reduce pain caused by contractions. The specimens were taken 10, 20, 30 and up to 45 minutes following a first injection of 11 to 13 ml bupivacaine 0.25%, before, 15 as well as 30 minutes after each repetitive dose and at childbirth. Immediately after cord clamping, blood sampling in the neonate was performed to evaluate bupivacaine concentrations in the umbilical artery and vein. Additionally, apgar scores and blood gas parameters were checked and compared with those of neonates, born without analgesic treatment of their mothers. Using bupivacaine 0.25% (average 12 ml) for epidural anaesthesia, the peak plasma levels (mean = 0.2 micrograms/ml) were found 10 minutes after application of the analgesic dose. In one patient a maximum bupivacaine plasma concentration (0.47 micrograms/ml) was determined 15 minutes after the second repetitive dose of 5 ml bupivacaine 0.25%. Apgar scores and results of blood gas analyses demonstrated no significant difference between neonates born spontaneously under regional anaesthesia or without any analgesic treatment of their mothers, respectively. Using bupivacaine 0.25% in epidural anaesthesia for pain relief in labour, we found maternal and neonatal plasma concentrations of the local anaesthetic drug far below the accepted threshold level which might produce systemic toxic reactions.
从24例接受硬膜外麻醉的患者身上采集外周静脉血样本，用于布比卡因分析（气相色谱法），硬膜外麻醉用于减轻宫缩引起的疼痛。在首次注射11至13毫升0.25%布比卡因后10、20、30以及长达45分钟时采集样本，在每次重复给药前、给药后15分钟以及30分钟时采集样本，分娩时也采集样本。脐带钳夹后立即对新生儿进行采血，以评估脐动脉和脐静脉中的布比卡因浓度。此外，检查阿氏评分和血气参数，并与未接受母亲镇痛治疗的新生儿进行比较。使用0.25%布比卡因（平均12毫升）进行硬膜外麻醉，镇痛剂量给药后10分钟发现血浆峰值水平（平均=0.2微克/毫升）。在一名患者中，第二次重复注射5毫升0.25%布比卡因后15分钟测定的布比卡因血浆最大浓度为0.47微克/毫升。阿氏评分和血气分析结果表明，分别在区域麻醉下自然分娩的新生儿与未接受母亲任何镇痛治疗的新生儿之间无显著差异。在硬膜外麻醉中使用0.25%布比卡因缓解分娩疼痛时，我们发现母体和新生儿血浆中局部麻醉药物的浓度远低于可能产生全身毒性反应的公认阈值水平。
