[Neonatal emergency: bupivacaine poisoning following maternal caudal anesthesia].

After maternal caudal anesthesia with bupivacaine life-threatening symptoms of bupivacaine intoxication occurred in the newborn. The local anesthetic had been injected directly into the fetal scalp. Cardiac shock caused by sinus bradycardia and impaired intracardial conduction (wide QRS-complex) was treated successfully. Seizures were absent. The bupivacain plasma level 90 min post partum was 3.6 mg/l, the elimination half-life 14 h. The symptoms presented in the newborn--especially the cardiovascular changes--coincide well with the results of animal experiments reported in the literature.