Skip to main content
SpringerLink
Log in

Absorption and Disposition of Local Anaesthetics in Relation to Regional Blood Flow Changes

  • Chapter
Current Concepts in Regional Anaesthesia

Part of the book series: Developments in Critical Care Medicine and Anaesthesiology ((DCCA,volume 7))

  • 61 Accesses

Abstract

Most of the clinically useful local anaesthetics are relatively lipid-soluble compounds and, therefore, pass across biological membranes without difficulty. Thus, delivery of the agents to such membranes by the blood supply may rate-limit their pharmacokinetics. This is particularly likely in the context of their systemic disposition once absorption into the general circulation has taken place. However, both diffusion and perfusion will play a role in translocation of local anaesthetics at sites of injection.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Blair MR. 1975. Cardiovascular pharmacology of local anaesthetics. Br.J.Anaesth., 47 (Suppl.): 247–252.

    PubMed  Google Scholar 

  2. Aberg G, Dhuner KG. 1972. Effects of mepivacaine (Carbocaine) on femoral blood flow in the dog. Acta Pharmacol. Toxicol.Kbh.), 31: 267–271.

    Article  CAS  Google Scholar 

  3. Wiklund L. 1977a. Human hepatic blood flow and its relation to systemic circulation during intravenous infusion of lidocaine. Acta Anaesth.Scand., 21: 148–160.

    Article  PubMed  CAS  Google Scholar 

  4. Wiklund L. 1977b. Human hepatic blood flow and its relation to systemic circulation during intravenous infusion of bupivacaine or etidocaine. Acta Anaesth. Scand., 21: 189–199.

    Article  PubMed  CAS  Google Scholar 

  5. Martin MA, Bax NDS, Tucker GT, Ward JW. 1980. Disopyramide and lignocaine: A comparison of cardiac effects using echocarcardiography. Br.J.Clin.Pharmacol., 10: 237–244.

    PubMed  CAS  Google Scholar 

  6. Stanton-Hicks Md’A. 1975. Cardiovascular effects of extradural.

    Google Scholar 

  7. Germann PAS, Roberts JG, Prys-Roberts C. 1979. The combination of general anaesthesia and epidural block 1: The effects of sequence of induction on haemodynamic variables and blood gas measurements in healthy patients. Anaesth. Int. Care, 7: 229–238.

    CAS  Google Scholar 

  8. Kennedy WF, Everett GB, Cobb LA, Allen GD. 1971. Simultaneous systemic and hepatic hemodynamic measurements during high peridural anesthesia in normal men. Anesth. Analg.:Curr.Res., 50: 1069–1077.

    Article  CAS  Google Scholar 

  9. Tucker GT, Mather LE. 1975. Pharmacokinetics of local anaesthetic agents. Br.J.Anaesth., 47 (Suppl.): 213–224.

    Article  PubMed  Google Scholar 

  10. Sivarajan M, Arnory DW, Lindbloom LE. 1976. Systemic and regional blood flow during epidural anesthesia without epinephrine in the rhesus monkey. Anesthesiology 45: 300–310.

    Article  PubMed  CAS  Google Scholar 

  11. Tucker GT, Mather LE. 1979. Clinical pharmacokinetics of local anaesthetics. Clin. Pharmacokin., 4: 241–278.

    Article  CAS  Google Scholar 

  12. Scott DB, Littlewood DG, Drummond GB, Buckley PF, Covino BG. 1977. Modification of the circulatory effects of extradural block combined with general anaesthesia by the addition of adrenaline to lignocaine solutions. Br. J.Anaesth., 49: 917–925.

    Article  PubMed  CAS  Google Scholar 

  13. Amory DW, Sivarajan M, Lindbloom LE. 1977. Systemic and regional blood flow during epidural anesthesia with epinephrine in the rhesus monkey. Acta Anaesth. Scand., 21: 423–429.

    Article  PubMed  CAS  Google Scholar 

  14. Quimby CW. 1965. Influence of blood loss on the duration of regional anesthesia. Anesth. Analg.:Curr. Res., 44: 387–390.

    Google Scholar 

  15. Morikawa KI, Bonica JJ, Tucker GT, Murphy TM. 1974. Effects of acute hypovolaemia on lignocaine absorption and cardiovascular response following epidural block in dogs. Br.J.Anaesth., 46: 631–635.

    Article  PubMed  CAS  Google Scholar 

  16. Benowitz NL, Forsyth RP, Melmon KL, Rowland M. 1974. Lidocaine disposition kinetics in monkey and man. II. Effects of hemorrhage and sympathomimetic drug administration. Clin.Pharmacol.Ther., 16: 99–109.

    PubMed  CAS  Google Scholar 

  17. Thomson PD, Melmon KL, Richardson JA, Cohn K, Steinbrunn W, Cudihee R, Rowland M. 1973. Lidocaine pharmacokinetics in advanced heart failure, liver disease and renal failure in humans. Ann.Int.Med., 78: 499–508.

    PubMed  CAS  Google Scholar 

  18. Bromage PR, Gertel M. 1972. Brachial plexus anesthesia in chronic renal failure. Anesthesiology 36: 488–493.

    Article  PubMed  CAS  Google Scholar 

  19. Morgan DH, Cousins MJ, McQuillan D, Thomas J. 1977. Disposition and placental transfer of etidocaine in pregnancy. Eur. J. Clin. Pharmacol., 12: 359–365.

    Article  PubMed  CAS  Google Scholar 

  20. Mather LE, Tucker GT, Murphy TM, Stanton-Hicks M, Bonica JJ. 1976. Haemodynamic drug interaction: peridural lignocaine and intravenous ephedrine. Acta Anaesth. Scand., 20: 207–210.

    Article  PubMed  CAS  Google Scholar 

  21. Tucker GT, Wiklund L, Berlin-Wahlen A, Mather LE. 1977. Hepatic clearance of local anaesthetics in man. J.Pharmacokin. Biopharm., 5: 111–122.

    Article  CAS  Google Scholar 

  22. Tucker GT. 1981. Principles of Pharmacokinetics. In: Therapeutic Drug Monitoring (eds. A Richens, V. Marks), London and Edinburgh, Churchill-Livingstone, pp 31–53.

    Google Scholar 

  23. Wiklund L, Tucker GT, Engberg G. 1977. Influence of intravenously administered ephedrine on splanchnic haemodynamics and clearance of lidocaine. Acta Anaesth. Scand., 21: 275–281.

    Article  PubMed  CAS  Google Scholar 

  24. Burney RG, Di Fazio CA. 1976. Hepatic clearance of lidocaine during N2O anesthesia in dogs. Anesth. Analg.:Curr.Res., 55: 322–325.

    CAS  Google Scholar 

  25. Feely J, Wilkinson GR, McAllister CB, Wood AJJ. 1982. Increased toxicity and reduced clearance of lidocaine by Cimetidine. Ann.Int. Med., 96: 592–593.

    PubMed  CAS  Google Scholar 

  26. DiFazio CA, Moscicki JC, DiFazio CJ. 1982. Cimetidine inhibits lidocaine plasma clearance. Anesthesiology 57: A188.

    Article  Google Scholar 

  27. Feely J, Guy E. 1983. Lack of effect of ranitidine on the disposition of lignocaine. Br.J.Clin.Pharmacol., 15: 378–379.

    PubMed  CAS  Google Scholar 

  28. Ochs HR, Carstens G, Greenblatt DJ. 1980. Reduction in lidocaine clearance during continuous infusion and by coadministration of propranolol. New Eng.J.Med., 303: 373–377.

    Article  PubMed  CAS  Google Scholar 

  29. Svendsen TL, Tango M, Waldorff S, Steiness E, Trap-Jensen J. 1982. Effects of propranolol and pindolol on plasma lignocaine clearance, Br.J.Clin.Pharmacol., 13: 223S–226S.

    PubMed  CAS  Google Scholar 

  30. Conrad KA, Byers JM, Finley PR, Burnham L. 1983. Lidocaine elimination: Effects of metoprolol and of propranolol. Clin.Pharmacol.Ther., 33:133–138.

    Article  PubMed  CAS  Google Scholar 

  31. Deacon CS, Lennard MS, Bax NDS, Woods HF, Tucker GT. 1981. Inhibition of oxidative drug metabolism by beta-adrenoceptor antagonists is related to their lipid-solubility. Br.J.Clin.Pharmacol., 12: 429–431.

    PubMed  CAS  Google Scholar 

  32. Tucker GT, Bax NDS, Lennard MS, A1-Asady S, Bharaj HS, Woods HF. 1983. Effects of beta-adrenoceptor antagonists on the pharmacokinetics of 1ignocaine. Br.J.Clin.Pharmacol., in press.

    Google Scholar 

  33. Mather LE, Runciman WB, Ilsley AH. 1982. Anesthesia-induced changes in regional blood flow: implications for drug disposition. Regional Anesthesia 7(Suppl.): S24–S37.

    Google Scholar 

Download references

Authors
  1. G. T. Tucker
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anaesthesiology, Leiden University Hospital, Leiden, The Netherlands

    Jack W. Van Kleef Md , Anton G. L. Burm Msc  & Johan Spierdijk Md ,  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1984 Martinus Nijhoff Publishers, The Hague

About this chapter

Cite this chapter

Tucker, G.T. (1984). Absorption and Disposition of Local Anaesthetics in Relation to Regional Blood Flow Changes. 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_21

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-6015-2_21

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-009-6017-6

  • Online ISBN: 978-94-009-6015-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation