Naropin should be used during pregnancy only if clearly needed. This does not preclude the use of Naropin after fetal organogenesis is completed or for obstetrical anesthesia or analgesia. The incidence and degree of toxicity depend upon the procedure performed, the type and amount of drug used, and the technique of drug administration. Adverse reactions in the parturient, fetus and neonate involve alterations of the central nervous system, peripheral vascular tone and cardiac function. Maternal hypotension has resulted from regional anesthesia with Naropin for obstetrical pain relief.
Local anesthetics produce vasodilation by blocking sympathetic nerves.
Elevating the patient's legs and positioning her on her left side will help prevent decreases in blood pressure. The fetal heart rate also should be monitored continuously, and electronic fetal monitoring is highly advisable. Epidural anesthesia has been reported to prolong the second stage of labor by removing the parturient's reflex urge to bear down or by interfering with motor function. Spontaneous vertex delivery occurred more frequently in patients receiving Naropin than in those receiving bupivacaine. Some local anesthetic drugs are excreted in human milk and caution should be exercised when they are administered to a nursing woman.