[Epidural anesthesia with carticaine in cesarean section. A comparison with bupivacaine]

The feasibility of 1.5% carticaine, an amide-type local anaesthetic agent, for epidural anaesthesia for Caesarean section was studied in 15 parturients. As a control, epidural anaesthesia in 15 parturients was done with 0.5% bupivacaine. The quality of anaesthesia before delivery was good in both groups. One additional dose of carticaine had to be given after delivery in order for the anaesthesia to last until the end of the operation. Apgar-scores, maternal and fetal pH and blood-gas values were similar in both groups. Maternal arterial serum concentration of bupivacaine at the time of delivery was 1.25 microgram/ml, while that of carticaine was only 0.48 microgram/ml. The lower serum concentration of carticaine is due to its rapid metabolization. The ratio of the unmetabolized drug to that of the metabolite found in maternal serum at the time of delivery was 0.75. Umbilical venous-maternal arterial serum concentration ratio in bupivacaine patients was 0.28 and in carticaine patients 0.32. The results suggest that carticaine is a feasible drug for Caesarean section.