毒理性
哺乳期使用总结：目前没有关于哺乳期间使用美普卡因的信息。基于其他局部麻醉药进入母乳的排泄量较低，哺乳期间单次使用美普卡因不太可能对哺乳婴儿产生不利影响。然而，可能会优先选择其他药物，特别是在哺乳新生儿或早产儿时。
在分娩期间给母亲用作局部麻醉的美普卡因有报道称会干扰一些婴儿的初始哺乳行为，但对产后前5天的体重增长没有影响。尽管没有针对美普卡因进行很好的研究，但看起来在良好的哺乳支持下，硬脊膜外麻醉药（无论是否加用芬太尼或其衍生物）对哺乳成功几乎没有或没有不利影响。分娩疼痛药物可能会延迟哺乳的开始。需要更多的研究来阐明美普卡因在分娩期间对哺乳结果的影响。
对哺乳婴儿的影响：截至修订日期，没有找到相关的已发布信息。
对哺乳和母乳的影响：在一项比较正常分娩期间硬脊膜外注射美普卡因、布比卡因和利多卡因用于镇痛的研究中，三组母乳喂养婴儿在分娩后前5天的体重变化没有差异。所有组的总体体重增长均在正常范围内。
在6名母亲在分娩前1小时内接受会阴阻滞美普卡因的婴儿中，有4名开始哺乳行为的时间较长，最初哺乳的次数少于10名在分娩期间未接受麻醉的母亲所生的婴儿。这些差异的长期后果没有报告。
一项全国性的调查比较了从晚期妊娠到产后12个月期间接受和未接受分娩疼痛药物的母亲及其婴儿的哺乳II期（lactogenesis II）的时间。药物类别包括仅硬脊膜外或脊髓麻醉、硬脊膜外或脊髓麻醉加另一种药物，以及其他疼痛药物。接受任何类别药物的母亲与未接受分娩疼痛药物的母亲相比，哺乳II期延迟（>72小时）的风险大约是两倍。
◉ Summary of Use during Lactation:No information is available on the use of mepivacaine during breastfeeding. Based on the low excretion of other local anesthetics into breastmilk, a single dose of mepivacaine during breastfeeding is unlikely to adversely affect the breastfed infant. However, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
Mepivacaine given during labor as a local anesthetic to the mother has been reported to interfere with initial nursing behavior of some infants, but not weight gain during the first 5 days postpartum. Although not well studied specifically with mepivacaine, it appears that with good breastfeeding support, epidural local anesthetics with or without fentanyl or one of its derivatives has little or no adverse effect on breastfeeding success. Labor pain medication may delay the onset of lactation. More study is required to clarify the effect of mepivacaine during labor on breastfeeding outcome.
◉ Effects in Breastfed Infants:Relevant published information was not found as of the revision date.
◉ Effects on Lactation and Breastmilk:In a study that compared extradural administration of mepivacaine, bupivacaine and lidocaine for analgesia during normal childbirth, no differences were found in weight changes over the first 5 days after delivery among the breastfed infants of the 3 groups. Overall weight gain was within normal limits for all groups.
Of 6 infants whose mothers received a pudendal block with mepivacaine within the hour before delivery, 4 took longer to begin nursing behavior and nursed less initially than 10 infants whose mothers received no anesthesia during labor. The long-term consequences of these differences were not reported.
A national survey of women and their infants from late pregnancy through 12 months postpartum compared the time of lactogenesis II in mothers who did and did not receive pain medication during labor. Categories of medication were spinal or epidural only, spinal or epidural plus another medication, and other pain medication only. Women who received medications from any of the categories had about twice the risk of having delayed lactogenesis II (>72 hours) compared to women who received no labor pain medication.
来源:Drugs and Lactation Database (LactMed)
