EFFECT OF ADRENALINE ON VENOUS PLASMA CONCENTRATIONS OF BUPIVACAINE AFTER INTERPLEURAL ADMINISTRATION

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Abstract
Bupivacaine 2.5 mg kg-1 (0.5 ml kg-1 of 0.5% solution), with or without adrenaline 5 .mu.g ml-1, was administered by interpleural injection to 12 patients after elective cholecystectomy. Non-compartmental analysis indicated that the addition of adrenaline had no effect on total body clearance, apparent volume of distribution at steady state or elimination half-life of bupivacaine. However, peak plasma concentrations were lower in the adrenaline group (mean (SD) [range]: 2.57 (0.61) [1.52-3.11] vs 3.22 (0.27) [2.84-3.53] .mu.g ml-1, P < 0.05) and the time to maximum concentration was delayed (median [range]: 25 [15-30] vs 15 [10-20] min, P < 0.05). Analgesia was variable and no differences were detected between the two groups. The addition of adrenaline appears prudent to minimize possible bupivacaine toxicity.