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) fig mt1 and median (range) tCPmax was 25 (10-60) min. A concentration of 4.43 ug mt' measured in one patient was not associated with toxic signs. During continuous infusion of bupivacaine for 120 h, CPmax was 4.9 (0.7) fig mt' 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. (Br. J. Anaesth. 1993; 70: 201–204)

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