The influence of epidural analgesia on platelet function and correlation with plasma bupivacaine concentrations.
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.
Odoom
J A
JA
Department of Anaesthesia, University of Amsterdam, The Netherlands.
Dokter
P W
PW
Sturk
A
A
Ten Cate
J W
JW
Sih
I L
IL
Bovill
J G
JG
D000244:Adenosine Diphosphate; D000368:Aged; D015360:Analgesia, Epidural; D002045:Bupivacaine / Q000097:blood*; D006801:Humans; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects*; D011468:Prostatectomy
D000244:Adenosine Diphosphate; D002045:Bupivacaine