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Anesth Analg 1988; 67:64-68
© 1988 International Anesthesia Research Society
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Neonatal Neurobehavior after Epidural Anesthesia for Cesarean Section

A Comparison of Bupivacaine and Chloroprocaine

Betty R. Kuhnert, PhD, Mary J. Kennard, BSN, and Patricia L. Linn, PhD

Received from the Departments of Obstetrics and Gynecology and the Perinatal Clinical Research Center of Case Western Reserve University, Cleveland, Ohio, and from the Department of Psychology, Antioch College, Yellow Springs, Ohio.

Abstract

Reports of whether or not bupivacaine affects neonatal neurobehavior have been contradictoy. The purpose of this study was to test the hypothesis that scores on the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) after epidural anesthesia with bupivacaine for cesarean section would not be different than those after chloroprocaine. Furthermore, if there were any effects, it was hypothesized that they would be related to cord blood levels of the drug. Fifty-five healthy mother/infant pairs were studied. Clinical characteristics, pharmacologic data, and BNBAS scores were obtained and analyzed using statistical techniques that included t-tests, repeated measures analysis of variance, and stepwise multiple regression. The results indicate that infants in the bupivacaine group do significantly better than those in the chloroprocaine group in the orientation cluster of the BNBAS (F[1,491 = 22, P > 0.001); this cluster reflects higher cortical functioning. Furthermore, there was improvement in the bupivacaine group in the regulation of state cluster with age, whereas there was no improvement in the chloroprocaine group (F[1,53] = 4.34, P > 0.01). This study suggests that performance on the BNBAS after exposure to bupivacaine is better than that after exposure to chloroprocaine.

Key Words: ANESTHESIA—obstetric • ANESTHETICS, LOCAL—bupivacaine, chloroprocaine






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.