What question did this study set out to answer?

To evaluate the in vitro effects of bupivacaine, lidocaine, and 2-chloroprocaine on maternal and neonatal platelet aggregation and beta-thromboglobulin release.

July 1, 1989Acta Anaesthesiologica Scandinavica

The effects of local anesthetics on maternal and neonatal platelet function

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Why the study?

Do local anesthetics (bupivacaine, lidocaine, 2-chloroprocaine) affect maternal and neonatal platelet function?

Population

Maternal and neonatal blood samples, along with non-pregnant subjects

Comparison

Bupivacaine, lidocaine, and 2-chloroprocaine at… vs Unexposed samples and non-pregnant subjects

Design

Preclinical

Authors

GGGilbert J. GrantNew York University SRSivam RamanathanCedars-Sinai Medical Center NPNileshkumar PatelInterventional Cardiology

Discussion

Member takes

Implication

May support epidural safety regarding platelets; leaves open in vivo clinical confirmation in obstetric settings.

Key Points

To evaluate the in vitro effects of bupivacaine, lidocaine, and 2-chloroprocaine on maternal and neonatal platelet aggregation and beta-thromboglobulin release.
Measured in vitro beta-thromboglobulin (beta-tg) release via radioimmunoassay and platelet aggregation stimulated by ADP, epinephrine, and collagen in the presence of 1, 10, 100, 500, or 1000 µg/ml of bupivacaine, lidocaine, or 2-chloroprocaine.
Assessed baseline spontaneous in vivo beta-tg release in maternal and neonatal blood compared with non-pregnant control blood.
Spontaneous in vivo beta-tg concentrations were approximately two-fold higher in maternal and neonatal blood compared with non-pregnant subjects (p < 0.025).
Platelet aggregation was not inhibited at clinical concentrations of 1 and 10 µg/ml, with consistent inhibition occurring only at concentrations of 500 µg/ml or greater; neonatal platelets were more susceptible to inhibition than maternal platelets, and lidocaine was the least effective inhibitor.
In vitro beta-tg release in maternal and neonatal samples was inhibited only at concentrations exceeding 1000 µg/ml, showing less inhibition than in non-pregnant controls.

Structured PICO

Do local anesthetics (bupivacaine, lidocaine, 2-chloroprocaine) affect maternal and neonatal platelet function?

Population

Maternal and neonatal blood samples, along with non-pregnant subjects

Intervention

Bupivacaine, lidocaine, and 2-chloroprocaine at concentrations of 1, 10, 100, 500, or 1000 micrograms/ml

Comparator

Unexposed samples and non-pregnant subjects

Outcome

In vitro beta-thromboglobulin (beta-tg) release and platelet aggregationsurrogate

Local anesthetics at concentrations achieved during normal maternal epidural anesthesia do not impair maternal or neonatal platelet function.

Cite This Study

Grant et al. (1989) studied this question.

synapsesocial.com/papers/6a8ea794af8fd2d34793858d https://doi.org/10.1111/j.1399-6576.1989.tb02934.x

Topics

Dual antiplatelet therapy

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The effects of local anesthetics on maternal and neonatal platelet function

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

The effects of local anesthetics on maternal and neonatal platelet function

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider