BUPIVACAINE ALTERS RED BLOOD-CELL PROPERTIES - A POSSIBLE EXPLANATION FOR NEONATAL JAUNDICE ASSOCIATED WITH MATERNAL ANESTHESIA

Cord blood [human] was incubated with lidocaine, mepivacaine, bupivacaine or buffer and red blood cell filterability was determined. Only bupivacaine at either 1 or 2 .mu.g/ml prolonged filterability by an average of 58-65% over red cells treated with buffer alone. Tritiated bupivacaine was bound to a greater extent to red cell ghosts from cord blood (24.6 .+-. 5.8%) than to adult red cell ghosts (14.6 .+-. 2.6%). Red cell survival was determined in 13-day-old rats infected with bupivacaine or buffer. At 2 h after injection, buffer-treated animals had a red cell survival of 96.9 .+-. 3.3%, whereas 2-h survival was reduced to 82.6 .+-. 8.7% for the animals injected with bupivacaine. The neonatal jaundice associated with maternal anesthesia, especially bupivacaine, may be related to the observations that these agents cross the placenta, bind to the red cell membrane and reduce its filterability, resulting in shortened red cell survival.