Cardiac function and sympathoadrenal activity in the newborn after cesarean section under spinal and epidural anesthesia

Left ventricular systolic time intervals, bupivacaine concentrations, adrenaline and noradrenaline levels were determined in 19 neonates delivered by elective cesarean section. Ten of the cesarean sections were performed under spinal and nine under epidural anesthesia. Plain bupivacaine 0.5% was used for the epidural anesthesia and bupivacaine 0.5% in glucose 8% for the spinals. The noradrenaline and adrenaline levels were higher in the neonates whose mothers received epidural anesthesia. The differences in catecholamine and bupivacaine concentrations were not associated with differences in left ventricular dynamics, or the timing of postnatal circulatory changes. The significant exposure of the neonate to bupivacaine, at maternal epidural anesthesia, seems to have no negative effect on early neonatal circulation in the healthy term infant.