Authors: Bhavani Shankar Kodali Monica Sa Rego A Murat Kaynar Richard D Urman
Publish Date: 2014/04/19
Volume: 28, Issue: 6, Pages: 906-910
Abstract
Amide local anesthetics are known to inhibit coagulation 2chloroprocaine is the only ester agent used in obstetric anesthesia It is used during obstetric emergencies and also to supplement inadequate epidural block produced by amide local anesthetics There is no study to date that has evaluated the effect of ester local anesthetics on blood coagulation and fibrinolysis in the parturientIn this study we obtained blood samples from healthy termparturients and mixed them with varying amounts of 2chloroprocaine for final concentrations ranging from 026 to 78 mM Thromboelastograph® was used to study the coagulation profile of these samplesChloroprocaine impaired coagulation in a dose dependent manner with increased R and K and decreased MA and α The difference when compared to saline controls reached statistical significance at a dose of 78 mM An additional significant finding was that 2chloroprocaine also enhanced fibrinolysisAmide local anesthetics are known to impair coagulation but 2chloroprocaine produced significant fibrinolysis in addition to decreasing coagulation This is the first study to date to demonstrate fibrinolytic properties of an ester local anesthetic Further study evaluations are required to determine the cause of the variation in fibrinolysis There is also a need to address the mechanism of increased fibrinolysis observed with 2chroloprocaine
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