We evaluated the rate of bilirubin production in vivo in newborns whose mothers received an epidural block with bupivacaine hydrochloride during labor and delivery. Bilirubin production was estimated in 23 full-term newborns whose mothers were treated with bupivacaine and in 20 controls by determining the end-tidal carbon monoxide concentration and the blood carboxyhemoglobin level corrected for ambient carbon monoxide. No significant difference was found between the mean end-tidal carbon monoxide concentrations for the bupivacaine-treated and the control groups (1.3 ± 0.5 and 1.4 ± 0.7 μL/kg/hour, respectively), or between the mean blood carboxyhemoglobin levels corrected for ambient carbon monoxide (0.54 ± 0.17 and 0.52 ± 0.18% saturation, respectively). These negative findings support the clinical studies, which have failed to demonstrate a causative connection between bupivacaine and neonatal jaundice.
© 1987 The American College of Obstetricians and Gynecologists