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Canadian Journal of Anesthesia, Vol 33, 130-137, Copyright © 1986 by Canadian Anesthesiologists' Society

The Effect of Lidocaine on Regional Blood Flows and Cardiac Output in the Non-Stressed and the Stressed Foetal Lamb

C. FRIESEN MD FRCPC1, R. YARNELL MD FRCPC1, C. BACHMAN MD FRCPC1, R. MEATHERAL PHD1, and D. BIEHL MD FRCPC1

1 Department of Anesthesia, University of Manitoba, Winnipeg, Manitoba

Address correspondence to: Dr. D. Biehl, Department of Anesthesia, St. Boniface General Hospital, 409 Tache Avenue, Winnipeg, Manitoba, R2H 2A6.

Lidocaine has been used in obstetrical anaesthesia for many years but there are still concerns about possible adverse affects of this drug on the foetus in utero. To examine in greater detail the effects of lidocaine in the foetus, the following two-part study was done.

In Part A, seven pregnant ewes were surgically prepared with maternal and foetal arterial and venous catheters. After recovery from surgery lidocaine was infused intravenously, initially into the ewe and then into both ewe and foetus. Blood lidocaine concentrations were monitored and foetal regional blood flows were determined by the radioactive microsphere method.

In Part B, 14 ewes were prepared as in Part A with the addition of an inflatable loop around the umbilical cord. During each study the loop was inflated to partially compress the cord and produce foetal acidosis. In all animals this cord compression was maintained for 30 minutes. In seven animals a lidocaine infusion was given, to examine the effect of lidocaine in the acidotic foetus. Organ blood flows were measured and cardiac outputs calculated.

The normal foetuses in Part A showed no change in organ blood flow or cardiac output with arterial lidocaine concentrations of 1.5-3.4 mg·ml-1. In the acidotic foetuses, lidocaine concentrations of 1.4-1.5 mg·ml-1. produced a tachycardia and an increase in cerebral blood flow compared to the control acidotic foetuses. There were no other significant changes.

We conclude that arterial lidocaine concentrations of less than 3.5 mg·ml-1 do not produce significant alterations in organ blood flow in normal foetal lambs. A lidocaine concentration of l.5 mg·ml-1 does not produce significant deterioration in acidotic foetuses.

Key Words: ANAESTHETICS, LOCAL: lidocaine • BRAIN: cerebral blood flow, asphyxion • PREGNANCY: foetus






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Copyright © 1986 by the Canadian Anesthesiologists' Society.