Placental transfer of lidocaine hydrochloride after prolonged continuous maternal intravenous administration

• Published in: Canadian journal of anesthesia Vol. 42; no. 4; pp. 338 - 340
• Main Authors: BANZAI, M, SATO, S, TEZUKA, N, KOMIYA, H, CHIMURA, T, HIROI, M
• Format: Journal Article
• Language: English
• Published: Toronto, ON Canadian Anesthesiologists' Society 01.04.1995
• Subjects: Adult; Amniotic Fluid - chemistry; Anesthetics. Neuromuscular blocking agents; Arrhythmias, Cardiac - blood; Arrhythmias, Cardiac - chemically induced; Arrhythmias, Cardiac - drug therapy; Biological and medical sciences; Female; Fetal Blood - chemistry; Fetofetal Transfusion - diagnosis; Humans; Infusions, Intravenous; Lidocaine - administration & dosage; Lidocaine - analysis; Lidocaine - blood; Lidocaine - pharmacokinetics; Maternal-Fetal Exchange; Medical sciences; Neuropharmacology; Obstetric Labor, Premature - prevention & control; Pharmacology. Drug treatments; Placenta - metabolism; Pregnancy; Pregnancy Complications, Cardiovascular - blood; Pregnancy Complications, Cardiovascular - chemically induced; Pregnancy Complications, Cardiovascular - drug therapy; Pregnancy, Multiple; Ritodrine - adverse effects; Twins; Human; Intravenous administration; Arrhythmia; Placental transfer; Cardiovascular disease; Local anesthetic; Case study; Pregnancy; Chemotherapy; Treatment; Heart disease; Female; Pharmacokinetics
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/BF03010711

We treated a patient with arrhythmia during pregnancy with prolonged intravenous administration of lidocaine hydrochloride. This was a case of twin-to-twin transfusion syndrome and the arrhythmia was caused by ritodrine therapy. In total, 14.1 g lidocaine (50 mg.hr-1 for 282 hr) were used. Since there are no descriptions of human placental transfer of lidocaine after such a prolonged continuous intravenous administration, we measured lidocaine concentrations in maternal and fetal serum, and in the amniotic fluid (AF) at delivery. Fetal serum lidocaine concentrations (donor: 0.83 microgram.ml-1; recipient: 0.82 microgram.ml-1) were lower than in the maternal serum (1.6 micrograms.ml-1), while the AF lidocaine concentrations (donor: 1.05 micrograms.ml-1; recipient: 1.04 micrograms.ml-1) were higher than those of the fetal sera. The fetal/maternal concentration ratios of lidocaine were 0.52 for the donor and 0.51 for the recipient, which were similar to those described previously after administration of lidocaine in labour.