Epidural anesthesia for cesarean section: a comparison of bupivacaine, chloroprocaine, and etidocaine.

The authors studied three groups of patients undergoing elective cesarean section during lumbar epidural anesthesia with bupivacaine, 0.75 per cent (15 patients), chloroprocaine, 3 per cent (15 patients) or etidocaine, 1 per cent (ten patients). Excellent sensory and motor block were obtained with chloroprocaine and bupivacaine; sensory anesthesia was inadequate with etidocaine in most patients. Onset of anesthesia, induction--delivery interval, and stay in the recovery room were all longer with bupivacaine when compared with chloroprocaine. Fetal outcomes, as determined by Apgar scores, acid--base status and neurobehavioral testing, were equally good in all groups. At delivery, fetal/maternal concentration ratio of bupivacaine was 0.31 and that of etidocaine, 0.25. The umbilical artery--umbilical vein blood concentration difference for etidocaine was significantly higher than that for bupivacaine. Excellent clinical results were obtained using either bupivacaine, 0.75 per cent, alone, or chloroprocaine, 3 per cent- for induction and maintenance of anesthesia, supplemented with bupivacaine, 0.25 per cent, before removal of the catheter.