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. 2015 Jul;22(7):791-7.
doi: 10.1177/1933719114561560. Epub 2015 Jan 5.

Transplacental Distribution of Lidocaine and Its Metabolite in Peridural Anesthesia Administered to Patients With Gestational Diabetes Mellitus

Elaine Christine Dantas Moises  1 , Luciana de Barros Duarte  2 , Ricardo de Carvalho Cavalli  3 , Daniela Miarelli Carvalho  3 , Gabriela Campos de Oliveira Filgueira  3 , Maria Paula Marques  4 , Vera Lucia Lanchote  4 , Geraldo Duarte  3
Affiliations

Transplacental Distribution of Lidocaine and Its Metabolite in Peridural Anesthesia Administered to Patients With Gestational Diabetes Mellitus

Elaine Christine Dantas Moises et al. Reprod Sci. 2015 Jul.

Abstract

Background: Neonatal effects of drugs administered to mothers before delivery depend on the quantity that crosses the placental barrier, which is determined by the pharmacokinetics of the drug in the mother, fetus, and placenta. Diabetes mellitus can alter the kinetic disposition and the metabolism of drugs. This study investigated the placental transfer of lidocaine and its metabolite monoethylglycinexylidide (MEGX) in pregnant women with gestational diabetes mellitus (GDM) submitted to peridural anesthesia.

Patients and methods: A total of 10 normal pregnant women (group 1) and 6 pregnant women with GDM (group 2) were studied, all at term. The patients received 200 mg 2% lidocaine hydrochloride by the peridural locoregional route. Maternal blood samples were collected at the time of delivery and, after placental expulsion, blood samples were collected from the intervillous space, umbilical artery, and vein for determination of lidocaine and MEGX concentrations and analysis of the placental transfer of the drug.

Results: The following respective lidocaine ratios between the maternal and the fetal compartments were obtained for groups 1 and 2: umbilical vein/maternal peripheral blood, 0.60 and 0.46; intervillous space/maternal blood, 1.01 and 0.88; umbilical artery/umbilical vein, 0.77 and 0.91; and umbilical vein/intervillous space, 0.53 and 0.51. The following MEGX ratios for groups 1 and 2 were, respectively, fetal/maternal, 0.43 and 0.97; intervillous space/maternal blood, 0.64 and 0.90; umbilical artery/umbilical vein, 1.09 and 0.99; and umbilical vein/intervillous space, 0.55 and 0.78.

Conclusion: Gestational diabetes mellitus did not affect the transplacental transfer of lidocaine but interfered with the transfer of MEGX, acting as a mechanism facilitating the transport of the metabolite.

Keywords: gestational diabetes mellitus; lidocaine; monoethylglycinexylidide; placental transfer; pregnancy.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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References

    1. Preston RA, Chung M, Gaffney M, Alonso A, Baltodano NM, Epstein M. Comparative pharmacokinetics and pharmacodynamics of amlodipine in hypertensive patients with and without type II diabetes mellitus. J Clin Pharmacol. 2001;41 (11):1215–1224. - PubMed
    1. Preston RA, Epstein M. Effects of diabetes on cardiovascular drug metabolism. Emerging clinical implications. Diabetes Care. 1999;22 (6):982–988. - PubMed
    1. Calderon IMP, Damasceno DC, Amorin RL, Costa RAA, Brasil MAM, Rudge MVC. Morphometric study of placental villi and vessels in women with mild hyperglycemia or gestational or overt diabetes. Diabetes Res Clin Pract. 2007;78 (1):65–71. - PubMed
    1. Pasanen M, Pelkonen O. Human placental xenobiotic and steroid biotransformations catalyzed by cytochrome P450, epoxide hydrolase, and glutathione S-transferase activities and their relationships to maternal cigarette smoking. Drug Metab Rev. 1990;21 (3):427–461. - PubMed
    1. Little BB. Pharmacokinetics during pregnancy: evidence-based maternal dose formulation. Obstet Gynecol. 1999;93 (5 pt 2):858–868. - PubMed

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