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.
Schweitzer
S A
SA
Department of Anaesthesia, St Vincent's Hospital, Fitzroy, Victoria, Australia.
Morgan
D J
DJ
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