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Related Experiment Videos

Pregnancy does not alter lidocaine toxicity.

H O Morishima1, M Finster, G R Arthur

  • 1Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY.

American Journal of Obstetrics and Gynecology
|May 1, 1990
PubMed
Summary

Pregnancy does not increase the toxicity of lidocaine, a local anesthetic, in sheep. This finding contrasts with bupivacaine toxicity and may relate to protein binding differences during pregnancy.

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Veterinary Medicine

Background:

  • Pregnant animals exhibit altered drug pharmacokinetics and pharmacodynamics.
  • Bupivacaine toxicity is enhanced in pregnant sheep, unlike mepivacaine.
  • Lidocaine shares properties with mepivacaine, suggesting similar pregnancy effects.

Purpose of the Study:

  • To investigate the central nervous and cardiovascular toxicity of lidocaine in pregnant sheep.
  • To compare lidocaine toxicity in pregnant versus nonpregnant ewes.
  • To elucidate the influence of pregnancy on lidocaine's toxicological profile.

Main Methods:

  • Intravenous infusion of lidocaine at 2 mg/kg/min in pregnant and nonpregnant ewes.
  • Monitoring for toxic manifestations: convulsions, hypotension, respiratory arrest, circulatory collapse.

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  • Comparison of drug doses and plasma concentrations at toxic endpoints.

    • Main Results:

    • Toxic effects occurred in a consistent sequence (convulsions to collapse) in both groups.
    • Similar doses of lidocaine induced toxicity in pregnant and nonpregnant ewes.
    • Lidocaine plasma concentrations at toxic events were comparable between pregnant and nonpregnant ewes.

    Conclusions:

    • Ovine pregnancy does not enhance the central nervous or cardiovascular toxicity of lidocaine.
    • Lidocaine's toxicity profile in pregnancy is similar to mepivacaine, not bupivacaine.
    • Pregnancy-induced alterations in serum protein binding may explain differential toxicity of local anesthetics.