Advertisement

Clinical Drug Investigation

, Volume 15, Issue 4, pp 309–317 | Cite as

Pharmacokinetic Profile of Epidurally Injected Bupivacaine in Awake Patients

  • R.H.T. Taverne
  • T.I. Ionescu
  • A. Van Dijk
Clinical Pharmacokinetic

Summary

In order to investigate the influence of general anaesthesia on the pharmacokinetics of bupivacaine 0.5% after a single, epidurally injected dose of 20ml (= 100mg), 5 patients, scheduled for surgical procedures appropriate for epidural anaesthesia without the need for combination with general anaesthesia, were studied. In all patients an arterial, central venous and intrathecal catheter were inserted for sampling of, respectively, arterial and central venous blood and cerebrospinal fluid (CSF), at regular intervals up to 12 hours after administration. Bupivacaine was analysed by gas chromatography The drug appeared after 2 minutes in the plasma and CSF samples, and was still detectable after 12 hours. There were no significant differences between the bupivacaine concentrations in the arterial and central venous plasma samples at all times. The same applied for the calculated plasma pharmacokinetic parameters at all intervals. The bupivacaine concentrations in the CSF were many dozen times higher than in the plasma samples at all times. There was no clear evidence of a pulmonary retention of bupivacaine in this study. From a pharmacokinetic point of view the epidural anaesthesia was largely spinal anaesthesia.

Keywords

Adis International Limited Bupivacaine Standard Deviation Epidural Anaesthesia Epidural Injection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Wiegand UW, Chou RC. Determination of bupivacaine in human plasma by high-performance liquid chromatography. J Chromatogr 1984; 311: 218–22PubMedCrossRefGoogle Scholar
  2. 2.
    Moore RA, Bullingham RES, McQuay HJ, et al. Spinal fluid kinetics of morphine and heroin. Clin Parmacol Ther 1984; 35: 40–5CrossRefGoogle Scholar
  3. 3.
    Veering BTh, Burm AGL, van Kleef JW, et al. Epidural anesthesia with bupivacaine: effects of age on neural blockade and pharmacokinetics. Anesth Analg 1987; 66: 589–93PubMedGoogle Scholar
  4. 4.
    Kietzmann D, Foth H, Geng WP, et al. Transpulmonary disposition of prilocaine, mepivacaine and bupivacaine in humans in the course of epidural anaesthesia. Acta Anaesthiol Scand 1995; 39: 885–90CrossRefGoogle Scholar
  5. 5.
    Arthur GR. Pharmacokinetics of local anesthetics. Handbook of experimental pharmacology. Berlin: Springer-Verlag, 1987: 81: 165–86Google Scholar
  6. 6.
    Tucker GT, Mather LE. Pharmacokinetics of local anaesthetic agents. Pharmacology of local anaesthetic agents. Br J Anaesth 1975; 47: 213–25PubMedCrossRefGoogle Scholar
  7. 7.
    Tucker GT, Mather LE. Properties, absorption and disposition of local anaesthetic agents. In: Cousins MJ, Bridenbaugh PO, editors. Neural blockade in clinical anesthesia and management of pain. 2nd ed. Philadelphia; JB Lippincott 1988: 47–110Google Scholar
  8. 8.
    Cousins MJ, Bridenbaugh PO. Spinal opioids and pain relief in acute care. In: Cousins MJ, Phillips GD, editors. Acute pain management. London: Churchill Livingstone, 1986; 151–97Google Scholar
  9. 9.
    Barr ML. The human nervous system: an anatomic viewpoint. New York: Harper International, 1979: 49–69Google Scholar
  10. 10.
    Wood HJ. Physiology, pharmacology and dynamics of CSF. In: Wood HJ, editor. Neurobiology of CSF. New York: Plenum Press, 1980: 2Google Scholar

Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • R.H.T. Taverne
    • 1
  • T.I. Ionescu
    • 2
  • A. Van Dijk
    • 3
  1. 1.Department of AnaesthesiologyHospital GOOI-NOORDBlaricumThe Netherlands
  2. 2.Institute of AnaesthesiologyUtrecht University HospitalUtrechtThe Netherlands
  3. 3.Centre of Hospital PharmacyUtrecht University HospitalUtrechtThe Netherlands

Personalised recommendations