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Journal of Anesthesia

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01-12-2014 | Original Article

The effects of 2-chloroprocaine on coagulation and fibrinolysis in the parturient: an in vitro study

Authors: Bhavani Shankar Kodali, Monica Sa Rego, A. Murat Kaynar, Richard D. Urman

Published in: Journal of Anesthesia | Issue 6/2014

Abstract

Purpose

Amide local anesthetics are known to inhibit coagulation. 2-chloroprocaine 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 parturient.

Methods

In this study, we obtained blood samples from healthy, term-parturients and mixed them with varying amounts of 2-chloroprocaine for final concentrations ranging from 0.26 to 7.8 mM. Thromboelastograph^® was used to study the coagulation profile of these samples.

Results

Chloroprocaine 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 7.8 mM. An additional significant finding was that 2-chloroprocaine also enhanced fibrinolysis.

Conclusions

Amide local anesthetics are known to impair coagulation, but 2-chloroprocaine 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 2-chroloprocaine.

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Title: The effects of 2-chloroprocaine on coagulation and fibrinolysis in the parturient: an in vitro study
Authors: Bhavani Shankar Kodali
Monica Sa Rego
A. Murat Kaynar
Richard D. Urman
Publication date: 01-12-2014
Publisher: Springer Japan
Published in: Journal of Anesthesia / Issue 6/2014
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-014-1826-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The effects of 2-chloroprocaine on coagulation and fibrinolysis in the parturient: an in vitro study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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