title: Plasma concentrations of bupivacaine and its enantiomers during continuous extrapleural intercostal nerve block.
abstract: Plasma concentrations of bupivacaine have been measured in 12 patients given bupivacaine through a paravertebral catheter placed under direct vision at thoracotomy. After an initial bolus of 0.5% bupivacaine 20 ml, mean (SEM) Cpmax was 1.45 (0.32) micrograms ml-1 and median (range) tCpmax was 25 (10-60) min. A concentration of 4.43 micrograms ml-1 measured in one patient was not associated with toxic signs. During continuous infusion of bupivacaine for 120 h, Cpmax was 4.9 (0.7) micrograms ml-1 and tCpmax 48 (5-96) h. No symptoms or signs of toxicity occurred. Separate measurement of R- and S-bupivacaine concentrations demonstrated significantly different concentration-time profiles.
authors.affiliation: Department of Thoracic Surgery, Bradford Royal Infirmary.
authors.forename: R G
authors.initials: RG
authors.lastname: Berrisford
authors.forename: S
authors.initials: S
authors.lastname: Sabanathan
authors.forename: A J
authors.initials: AJ
authors.lastname: Mearns
authors.forename: B J
authors.initials: BJ
authors.lastname: Clarke
authors.forename: A
authors.initials: A
authors.lastname: Hamdi
mesh_terms: D000328:Adult; D002045:Bupivacaine / Q000097:blood* / Q000493:pharmacokinetics / Q000633:toxicity; D005260:Female; D006801:Humans; D007367:Intercostal Nerves; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D010149:Postoperative Pain / Q000517:prevention & control; D013237:Stereoisomerism; D013908:Thoracotomy
chemical_list: D002045:Bupivacaine