Perinatal bupivacaine and infant behavior in rhesus monkeys

To assess the effect of perinatal epidural bupivacaine analgesia on infant behavioral development, bupivacaine (1.2 mg/kg) was administered to term-pregnant rhesus monkeys (treated, n = 11, procedural controls, n = 8) and infant behavior was evaluated for 1 year using a test battery including infant neurobehavioral tests, observation of spontaneous behavior, and structured cognitive testing. No adverse effects of bupivacaine were detected for neonatal neurobehavior, early cognitive abilities, or performance of cognitive tasks by older infants. Bupivacaine infants directed more, shorter fixations at visual stimuli during visual novelty preference testing. Observation of behavior maturation patterns showed that the increase in manipulatory activity that normally occurs at 2 months of age was delayed in bupivacaine infants, and the increase in motor disturbance behaviors that normally occurs at 10 months of age was prolonged. These results are interpreted in terms of life-history and brain maturation landmarks that appear at these ages. The data suggest that epidural bupivacaine does not cause neonatal abnormalities or specific cognitive deficits but can alter the normal course of behavioral development.