Maternal and neonatal effects of single-dose epidural anesthesia with lidocaine and morphine for cesarean delivery.

Two per cent lidocaine (18-20 ml) with epinephrine 1:200,000 plus 4 mg of morphine was given as a single epidural injection over 3 minutes for elective cesarean section in 60 healthy mothers at term. It provided effective, safe and adequate analgesia in the postoperative period. There was no evidence of neonatal depression related to the epidural morphine as judged by Apgar scores at 1 and 5 minutes and umbilical venous pH at birth. Maternal and umbilical venous levels of morphine were measured and found to be low at birth. However, this study was done only in healthy mothers not in labor and having a term fetus. We do not recommend using this technique in complicated obstetric patients.