Determination of Low Levels of Bupivacaine (Marcaine®) in Plasma During Epidural Analgesia

The increasing demand for epidural analgesia during childbirth focusses attention on the possible side effects of the analgesic drug in mother and child. Estimation of drug levels in maternal and foetal (umbilical cord) plasma serves to supervise the degree of leakage from the application site. The drugs used in this type of analgesia are potent myocardial suppressants and they are able to cause a constriction of the uterine vessels, in this way decreasing the utero-placental bloodflow (1). A correlation can also be made between cardiac activity of the child and uterine contraction in the mother (cardiotocography) as well as with the general condition of the newborn, e. g. Apgar score, etc. (2).