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2-Chloroprocaine for local perineal infiltration.

Abstract：

:Lidocaine was recently found to rapidly cross the placenta and result in considerable fetal exposure after local infiltration of the perineum for episiotomy. For this reason, a more appropriate agent for local perineal infiltration might be a drug with rapid metabolism and inactive metabolites. 2-Chloroprocaine, an ester-linked local anesthetic agent, is available but is not commonly used for this procedure. The purpose of this study was to evaluate the placental transfer of 2-chloroprocaine after local perineal infiltration. The drug was administered to 17 normal term pregnant women for episiotomy. After local perineal infiltration, the levels of 2-chloroprocaine and/or its metabolite, chloroaminobenzoic acid, were quantitated in maternal and neonatal plasma or urine. The pharmacologic data indicated that 2-chloroprocaine was nondetectable at delivery in maternal and umbilical cord vein; one patient had trace levels in the cord. Chloroprocaine was not detectable in neonatal plasma, but chloroaminobenzoic acid was detectable in both maternal and cord vein plasma. Mean levels of chloroaminobenzoic acid in maternal plasma at delivery were 1.04 +/- 0.32 micrograms/ml, and mean levels in cord vein were 0.35 +/- 0.54 micrograms/ml. Clinically, 2-chloroprocaine provided good analgesia. These results indicate that very little, if any pharmacologically active drug, reaches the fetus after local perineal infiltration with 2-chloroprocaine. Therefore 2-chloroprocaine appears to be preferable to lidocaine when used for local perineal infiltration.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Philipson EH,Kuhnert BR,Syracuse CD

doi

10.1016/s0002-9378(87)80313-7

subject

Has Abstract

pub_date

1987-11-01 00:00:00

pages

1275-8

issue

5

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(87)80313-7

journal_volume

157

pub_type

杂志文章

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