Abstract
Abnormal hearing responses were found in a group of term infants born by Caesarian section after maternal administration of epidural anesthesia in a study comparing the effect of lidocaine and lidocaine-epinephrine combination on the infant's neurobe-havioral response. Twenty-nine infants born after lidocaine anesthesia (mean dose 455±85mg) had an umbilical artery lidocaine level of 1.18±0.50ug/ml, and umbilical venous concentration of 1.87±0.70ug/ml compared to 14 born after lidocaine epinephrine (mean dose 406±86mg) that resulted in a UV level of 1.43±0.40ug/ ml and a UA level of 1.06±0.30 ug/ml. All infants were evaluated with the neurobehavioral index (ENNS) at four and 24 hours of age.
Both groups demonstrated optimal responses during both time periods in muscle tone and reflex items including pinprick, pull to sit, arm recoil, truncal tone, body tone, rooting, suck, Moro, placing, and alerting. However, response to sound was abnormal in 65% of the lidocaine and 68% of the combined therapy group, comparable to similar results following 0.5% bupivacaine.
The results of this study suggest that maternal anesthesia with these agents adversely affects hearing in the newborn infant, possible mechanisms including conduction delay in the eighth nerve or other neuronal pathways.
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Ostfeld, B., Friedman, S., Menke, T. et al. 1472 THE EFFECT OF PRENATAL LIDOCAINE ON HEARING RESPONSES IN TERM INFANTS. Pediatr Res 19, 356 (1985). https://doi.org/10.1203/00006450-198504000-01496
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DOI: https://doi.org/10.1203/00006450-198504000-01496