title: The influence of epidural analgesia on platelet function and correlation with plasma bupivacaine concentrations.
abstract: The effect of epidural anaesthesia with bupivacaine 0.5% on platelet aggregation was studied in seven patients undergoing transurethral resection of the prostate. Peak plasma concentrations of bupivacaine 470 +/- 270 ng ml-1 occurred at 30 min after administration. At that time there were no significant changes in platelet aggregation. However, the maximum rate of the primary- and secondary-aggregation velocities induced by 1.0 microM ADP were significantly decreased at 1 h and 3 h after bupivacaine administration. The maximum percentage ADP-induced platelet aggregation was also decreased significantly at 1 h and 3 h. The minimum concentration of ADP required to induce secondary-phase platelet aggregation was significantly increased at 1 h but not at 3 h. There was a significant correlation between bupivacaine concentrations and all platelet aggregation parameters except the maximum ADP-induced aggregation. Platelet inhibition occurred at plasma bupivacaine concentrations that were considerably lower than those needed to produce similar inhibition in vitro.
authors.affiliation: Department of Anaesthesia, University of Amsterdam, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Odoom
authors.forename: P W
authors.initials: PW
authors.lastname: Dokter
authors.forename: A
authors.initials: A
authors.lastname: Sturk
authors.forename: J W
authors.initials: JW
authors.lastname: Ten Cate
authors.forename: I L
authors.initials: IL
authors.lastname: Sih
authors.forename: J G
authors.initials: JG
authors.lastname: Bovill
mesh_terms: D000244:Adenosine Diphosphate; D000368:Aged; D015360:Analgesia, Epidural; D002045:Bupivacaine / Q000097:blood*; D006801:Humans; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects*; D011468:Prostatectomy
chemical_list: D000244:Adenosine Diphosphate; D002045:Bupivacaine