title: Plasma concentrations of bupivacaine during extradural anaesthesia for caesarean section. The effect of adrenaline.
abstract: The clinical effects and plasma levels associated with the use of 0.5% bupivacaine with and without the addition of 1:200,000 adrenaline (5 micrograms/ml) were studied in 30 patients who underwent extradural anaesthesia for elective Caesarean section. The addition of adrenaline to bupivacaine prolongs analgesia, reduces the degree of hypotension and delays its onset. Plasma bupivacaine levels were consistently lower when adrenaline was added, but this difference was significant only at 10 minutes after the initial dose. Prolonging the interval between increments seems to be a more reliable way to reduce plasma concentration than the addition of the catecholamine.
authors.affiliation: Department of Anaesthetics, Queen's University of Belfast.
authors.forename: C M
authors.initials: CM
authors.lastname: Wilson
authors.forename: J
authors.initials: J
authors.lastname: Moore
authors.forename: R G
authors.initials: RG
authors.lastname: Ghaly
authors.forename: R
authors.initials: R
authors.lastname: Flynn
authors.forename: E
authors.initials: E
authors.lastname: McClean
authors.forename: J W
authors.initials: JW
authors.lastname: Dundee
mesh_terms: D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D002045:Bupivacaine / Q000008:administration & dosage / Q000097:blood*; D002585:Cesarean Section; D004338:Drug Combinations; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D011247:Pregnancy
chemical_list: D004338:Drug Combinations; D002045:Bupivacaine; D004837:Epinephrine