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Placental transfer of lidocaine hydrochloride after prolonged continuous maternal intravenous administration

  • Michio Banzai
  • Satoshi Sato
  • Naohiro Tezuka
  • Hiromi Komiya
  • Tetsuro Chimura
  • Masahiko Hiroi
Clinical Reports

Abstract

We treated a patient with arrhythmia during pregnancy with prolonged intravenous administration of lidocaine hydrochloride. This was a case of twin-to-twin transfusion syndrome and the arrhythmia was caused by ritodrine therapy. In total, 14.1 g lidocaine (50 mg · hr−1 for 282 hr) were used. Since there are no descriptions of human placental transfer of lidocaine after such a prolonged continuous intravenous administration, we measured lidocaine concentrations in maternal and fetal serum, and in the amniotic fluid (AF) at delivery. Fetal serum lidocaine concentrations (donor: 0.83 μg · ml−1; recipient: 0.82 μg · ml−1) were lower than in the maternal serum (1.6 μg · ml−1), while the AF lidocaine concentrations (donor: 1.05 μg · ml−1; recipient: 1.04 μg · ml−1) were higher than those of the fetal sera. The fetal/maternal concentration ratios of lidocaine were 0.52 for the donor and 0.51 for the recipient, which were similar to those described previously after administration of lidocaine in labour.

Key Words

anaesthesia: obstetric anaesthetics, local: lidocaine uterus: tocolytics, ritodrine complication: arrhythmia pharmacokinetics: placental transfer, serum concentration placenta: drug transfer 

Résumé

Nous avons traité l’arythmie d’une parturiente porteuse de jumeaux avec de l’hydrochlorure lidocaline iv. Il s’agissait d’un syndrome de gémellité perfuseur-perfusé et l’arythmie était consécutive au traitement à la ritodrine. En tout, 14,1 g (50 mg · h−1 pour 282 h) de lidocaine ont été administrées. Comme on n’a jamais rapporté de données sur le transfert placentaire de la lidocaïne après une administration iv aussi prolongée, nous avons mesuré à l’accouchement les concentrations sériques maternelles et foetales de lidocaïne, et la concentration sérique de liquide amniotique (LA) de lidocaïne. Les concentrations sériques (perjuseur: 0,83 μg · ml−1; perfusé: 0,82 μg · ml−1) étaient moins élevées que dans le sérum matemel (1,6 μg · ml−1), alors que dans le LA (perfuseur: 1,05 μg · ml−1; perfusé; 1.04 μg · ml−1) les concentrations étaient plus élevées que dans le sérum foetal. Les rapports concentration foetus/ mère de lidocaïne étaient de 0,52 pour le perfuseur et de 0,51 pour le perfusé et identiques à ceux trouvés après l’administration de lidocaïne pendant le travail.

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Copyright information

© Canadian Anesthesiologists 1995

Authors and Affiliations

  • Michio Banzai
    • 1
  • Satoshi Sato
    • 1
  • Naohiro Tezuka
    • 1
  • Hiromi Komiya
    • 1
  • Tetsuro Chimura
    • 1
  • Masahiko Hiroi
    • 1
  1. 1.Department of Obstetrics and GynecologyYamagata University School of MedicineYamagataJapan

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