title: The effects of bupivacaine and pipecoloxylidide on platelet function in vitro.
abstract: The influence of bupivacaine and its major metabolite, pipecoloxylidide, on human platelet function was studied in vitro. Significant inhibition of ADP and collagen-induced platelet aggregation occurred only with concentrations of bupivacaine above 10 micrograms.ml-1. This concentration (10-25 micrograms.ml-1) is much higher than would be expected in routine clinical use of bupivacaine for epidural analgesia. The inhibition of platelet aggregation was associated with a significant decrease in beta-thromboglobulin secretion. In contrast, pipecoloxylidide had no effect on platelet aggregation or the beta-thromboglobulin release. We conclude that the previously reported 30-min time-lag between the maximal plasma concentration of bupivacaine and the inhibition of platelet aggregation is unlikely to be due to a metabolism of bupivacaine to pipecoloxylidide.
authors.affiliation: Department of Anaesthesia, University of Amsterdam, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Odoom
authors.forename: A
authors.initials: A
authors.lastname: Sturk
authors.forename: P W
authors.initials: PW
authors.lastname: Dokter
authors.forename: J G
authors.initials: JG
authors.lastname: Bovill
authors.forename: J W
authors.initials: JW
authors.lastname: ten Cate
authors.forename: J
authors.initials: J
authors.lastname: Oosting
mesh_terms: D000328:Adult; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism / Q000502:physiology; D002045:Bupivacaine / Q000031:analogs & derivatives* / Q000494:pharmacology*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D001620:beta-Thromboglobulin / Q000378:metabolism
chemical_list: D010975:Platelet Aggregation Inhibitors; D001620:beta-Thromboglobulin; C025149:2',6'-pipecoloxylidide; D002045:Bupivacaine