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Am J Perinatol 1987; 4(2): 164-166
DOI: 10.1055/s-2007-999764
ORIGINAL ARTICLE

© 1987 by Thieme Medical Publishers, Inc.

Lidocaine Toxicity After Maternal Pudendal Anesthesia in a Term Infant with Fetal Distress

Mary Ellen A. Bozynski1 , Lorraine Baas Rubarth2 , Jayant A. Patel3
  • 1Department of Pediatrics, Section of Newborn Services, University of Michigan Medical Center, Ann Arbor, Michigan
  • 2Department of Nursing, Catherine McAuley Health Center, Ann Arbor, Michigan
  • 3Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan
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Publication History

Publication Date:
04 March 2008 (online)

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ABSTRACT

There have been many reports of lidocaine toxicity especially after maternal paracervical block anesthesia. We recently treated a term infant with evidence of fetal distress who presented with symptoms of lidocaine toxicity after maternal pudendal anesthesia. The infant developed apnea and bradycardia soon after birth which responded to mechanical ventilation and epinephrine. A prolonged Q-T interval was noted on day 1 which normalized by day 3. Cord blood was assayed and revealed an elevated lidocaine level. Lidocaine toxicity has been associated with fetal distress secondary to fetal ion trapping in the presence of acidosis. Although good response to supportive therapy occurred in our patient, other methods of therapy such as exchange transfusion and treatment of seizures may be required in some cases. Awareness of this now uncommon syndrome will lead to prompt diagnosis, appropriate work-up, and management.

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