Neonatal neurobehavioral responses after epidural anesthesia for cesarean section using lidocaine and bupivacaine.

We compared the early neonatal neurobehavioral responses after lumbar epidural anesthesia for elective cesarean section using 2% lidocaine (n = 10) and 0.5% bupivacaine (n = 21). We tested the infants at 4 and 24 hr after birth and found that the neonates in the lidocaine group scored as well as those in the bupivacaine group on all parameters of the early neonatal neurobehavioral score (ENNS). In fact on one parameter, sucking response at 24 hr, the neonates in the lidocaine group scored significantly higher than those in the bupivacaine group. We concluded that 2% lidocaine does not compromise newborn outcome when compared to 0.5% bupivacaine and that it provides a satisfactory choice for use during elective cesarean section in healthy pregnancies. This conclusion is important in the light of the current concern over the safety of the use of chloroprocaine and bupivacaine in obstetric anesthesia.