Abstract
The processes that determine the fate of a local anaesthetic agent after its injection into the subarachnoid or epidural space are local disposition, systemic absorption and systemic disposition.1 These processes are not independent, but for the ease of understanding they are usually considered separately. In this paper we will concentrate on local disposition and systemic absorption. For a review on the systemic disposition the reader is referred to the existing literature.1, 2 Some of the factors that affect the systemic absorption and disposition are dealt with in the chapter by Tucker on the effects of regional blood flow changes.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Tucker GT, Mather LE. Absorption and disposition of local anesthetics. In: Neural Blockade, Ed. Cousins MJ, Bridenbaugh PO. 1980. J.B. Lippincott Co., pp 45–85, Philadelphia/Toronto.
Tucker GT, Mather LE. Clinical pharmacokinetics of local anesthetics. Clin Pharmacokinet. 4: 241–278, 1979.
Rieselbach RE, Di Chiro G, Freireich EJ, Rall D.P. Subarachnoid distribution of drugs after lumbar injection. N. Engl. J. Med. 267: 1273–1278, 1962.
Burn JM, Guyer PB, Langdon L. The spread of solutions injected into the epidural space. A study using epidurograms in patients with the lumbosciatic syndrome. Br. J. Anaesth. 45: 338–345, 1973.
Bromage, PR. Mechanism of action of extradural analgesia. Br. J. Anaesth. 47, Suppl.: 199–211, 1975.
Neigh JL, Kane PB, Smith TC. Effects of speed and direction of injection on the level and duration of spinal anesthesia. Anesth. Analg. 49: 912–918, 1970.
Erdemir HA, Soper LE, Sweet RB. Studies of factors affecting peridural anesthesia. Anesth. Analg. 44: 400–404, 1965.
Greene NM. 1981. Physiology of spinal anesthesia, 3rd ed. Williams and Wilkins, Baltimore/London.
Barclay DL, Renegar OJ, Nelson EW. The influence of inferior vena cava compression on the level of spinal anesthesia. Am. J. Obstet. Gynecol. 101: 792–800, 1968.
Bromage PR. 1978. Epidural analgesia. W.B. Saunders Company, Philadelphia.
Bromage PR. Spread of analgesic solutions in the epidural space and their site of action: a statistical study. Br. J. Anaesth. 34: 161–178, 1962.
Mörch ET, Rosenberg MK, Truant AT. Lidocaine for spinal anaesthesia. Acta Anaesthesiol. Scand. 1: 105–115, 1957.
Meyer J, Nolte H. Liquorkonzentration von Bupivacaine nach subduraler Applikation. Regional-Anaesthesie 1: 38–40, 1978.
Lund PC, Covino BG. Distribution of local anesthetics in man following peridural anesthesia. J. Clin. Pharmacol 7: 324–329, 1967.
Wilkinson GR, Lund PC. Bupivacaine levels in plasma and cerebrospinal fluid following peridural administration. Anesthesiology 33: 482–486, 1970.
Van Kleef JW. 1981. A clinical evaluation of bupivacaine (MarcaineR) 0.5% versus 0.75%. Ph.D. Thesis, State University of Leiden.
Burm AG, Van Kleef JW, Gladines MP, Spierdijk J and Breimer DD: Plasma concentrations of lidocaine and bupivacaine after subarachnoid administration. Anesthesiology 59: 191–195, 1983.
Denson DD, Bridenbaugh PO, Turner PA, Phero JC and Raj PP. Neural blockade and pharmacokinetics following subarachnoid lidocaine in the rhesus monkey. I. Effects of epinephrine. Anesth. Analg. 61: 746–750, 1982.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1984 Martinus Nijhoff Publishers, The Hague
About this chapter
Cite this chapter
Burm, A.G.L., Van Kleef, J.W. (1984). Pharmacokinetics in Spinal and Epidural Anaesthesia. In: Van Kleef, J.W., Burm, A.G.L., Spierdijk, J. (eds) Current Concepts in Regional Anaesthesia. Developments in Critical Care Medicine and Anaesthesiology, vol 7. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-6015-2_18
Download citation
DOI: https://doi.org/10.1007/978-94-009-6015-2_18
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-009-6017-6
Online ISBN: 978-94-009-6015-2
eBook Packages: Springer Book Archive