Background
Local anesthetics have been associated with spinal neurotoxicity, including the risk of persistent neurological injury. Pregnancy is known to increase the sensitivity of nervous tissue to local anesthetics, potentially elevating the risk of neurological deficits in obstetric patients following spinal block. This study aimed to investigate the effects of pregnancy on the neurotoxicity of intrathecal bupivacaine.
Methods
Pregnant and non-pregnant rabbits were administered three injections of either 0.375 % or 0.75 % bupivacaine, or normal saline, at 48-h intervals (average volume: 200 μl). Seven days after the first injection, electron microscopic scores (EMS), spinal neuronal apoptotic rates, intracellular Ca2+ concentrations, and mitochondrial membrane potential were evaluated.
Results
The EMS indicated more severe neurotoxicity in non-pregnant rabbits compared to pregnant rabbits in the bupivacaine-treated groups (median [Q1-Q3]: 23 [21–26] vs. 21 [18.5–24], P = 0.045). Pregnant rabbits exhibited significantly lower apoptosis rates and intracellular Ca2+ concentrations, along with a higher mitochondrial membrane potential compared to their non-pregnant counterparts (0.99 % ± 1.33 % vs. 2.03 % ± 2.09 %, P < 0.01; 240 ± 104 vs. 257 ± 112, P < 0.01; 84.1 % ± 6.1 % vs. 69.9 % ± 15.4 %, P < 0.01).
Conclusion
These findings indicated that pregnancy protects nervous tissue against the toxicity of intrathecal bupivacaine.
Conclusion: These findings suggest that pregnancy confers a protective effect on nervous tissue against the neurotoxicity induced by intrathecal bupivacaine.
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