Lumbar Epidural Anesthesia for Cesarean Section : Lidocaine Dose and Its Plasma Concentration / 대한마취과학회지

ABSTRACT

The effects of lumbar epidural anesthesia for eleetive Cesarean section with 2% 1idocaine containing 1 200,000 epinephrine on newborn Apgar scores, maternal vein, umbilica1 vein, and umbilical artery plasma concentration of lidocsine at delivery were studied in 9 parturients. With patients in a sitting position, single epidural anesthesias were performed with a 17 gauge Tuohy needle. 25ml of 2% lidocaine with 1 200,000 epinephrine was used as a local anesthetic. Maternal venous blood samples for the measurement of plasma concentrations of lidocaine were obtained from an indwelling venous catheter at the time of delivery. In addition, blood was collected from a doubly clamped section of umbilical cord for the measurement of lidocaine plasma levels. Neonates were evaluated by Apgar scores at 1 and 5 min, Apger scores were assigned by the pediatricians. Maternal venous lidocaine concentrations at the time of delivery(mean+/-SD) were 3.00+/-0.45ug /ml, and the ratio between umbilical and maternal venous levels was 0.535+/-0.163. All newborns had Apgar scores of 7 or more at 1 min and 5 min, and the was no significant difference between the 1 min and 5 min Apgar scores. It is concluded that epidural anesthesia using 25ml of 2% lidocaine with 1 200,000 epinephrine for Cesarean section has no adverse effects on both mothers and neonates.