Title: Pharmacokinetics of different concentrations of levobupivacaine for lumbar epidural anesthesia
Abstract: Objective To investigate the pharmacokinetics of different concentrations of levobupivacaine for lumbar epidural anesthesia.Methods Twenty ASA Ⅰ or Ⅱ patients of both sexes aged 35-59 yr scheduled for elective rectum or colon cancer operation under general anesthesia combined with epidural block were randomly divided into 2 groups(n=10 each):group Ⅰ 0.75% levobupivacaine and group Ⅱ 0.5% levobupivacaine.Epidural block was performed at L1-2 interspace.Group Ⅰ and Ⅱ received epidural 0.75% and 0.5% levobupivacalne 2 mg/kg(containing adrenaline 5 μg/kg)injected slowly over 2 min respectively.Thirty minutes after epidural levobupivacaine,general anesthesia was induced withγ-hydroxybutyrate 60-80 mg/kg,and remifentanil 1-2 μg/kg.Tracheal intubation was facilitated with succinyl choline 1-1.5 mg/kg and the patients were mechanically ventilated.Anesthesia was maintained with inhalation of nitrous oxide and O2(1:1)and continuous blockade were assessed after epidural levobupivacaine.Blood samples were taken from central vein at 0,10,20,30,45,60,90,120,210,300,420,540,660 and 840 min after epidural levobupivacaine for determination of plasma concentration of levobupivacaine by high performance liquid chromatography.Results The plasma concentration-time curves of levobupivacaine were fitted to a two-compartment open model in the two groups and there was no significant difference in the pharmacokinetic profiles between the two groups.The onset time of sensory and motor block was shorter and the duration of the two blocks was longer with 0.75% levobupivacaine as compared with 0.5% levobupivacaine.The incidences of nausea and vomiting and hypotension were low and no severe cardiovascular and neurological side-effects developed.Conclusion The pharmacokinetic parameters do not differ significantly between epidural 0.75% and 0.5% levobupivacaine when the total amount is the same.Epidural anesthesia with either 0.75% or 0.5% levobupivacaine is safe.
Key words:
Bupivacaine; Pharmacokinetics; Anesthesia,epidural
Publication Year: 2008
Publication Date: 2008-03-20
Language: en
Type: article
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