Plasma bupivacaine concentrations during postoperative continuous epidural analgesia.
Postoperative analgesia and plasma concentrations of bupivacaine were evaluated in six patients receiving intermittent epidural bupivacaine for a period of 72 hours following large bowel surgery. Repeated doses were administered every hour by a new automatic, specially designed pump. Venous plasma bupivacaine concentrations showed accumulation for up to 48-60 hours during administration and were mostly less than 2 micrograms/ml except in an elderly, frail patient in whom a peak of 3.9 micrograms/ml was observed. This convenient, low-dose, pulsed technique provided excellent analgesia although special care may be necessary in the elderly and frail patient if potentially toxic levels are to be avoided.
Department of Anaesthesia, St Vincent's Hospital, Fitzroy, Victoria, Australia.
S A
SA
Schweitzer
D J
DJ
Morgan
D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural / Q000295:instrumentation; D002045:Bupivacaine / Q000008:administration & dosage / Q000097:blood*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007420:Intestine, Large / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000097:blood / Q000628:therapy*
D002045:Bupivacaine