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Anesth Analg 2008; 107:1182-1184
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e318181bb4d
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PEDIATRIC ANESTHESIOLOGY

Pharmacokinetics of Levobupivacaine (2.5 mg/kg) After Caudal Administration in Children Younger Than 3 Years

Luis I. Cortínez, MD*, Ricardo Fuentes, MD*, Sandra Solari, MD{dagger}, Paola Ostermann, MD{ddagger}, Miguel Vega, MD{ddagger}, and Hernán R. Muñoz, MD, MSc*

From the *Departamento de Anestesiología y {dagger}Laboratorio Clínico, Facultad de Medicina, Pontificia Universidad Católica de Chile, and {ddagger}Servicio de Anestesiología, Hospital Josefina Martínez, Santiago, Chile.

Address correspondence and reprint requests to Dr. Luis I. Cortínez, Departamento de Anestesiología, Hospital Clínico Universidad Católica, Marcoleta 367, Santiago, Chile. Address e-mail to licorti{at}med.puc.cl.

Abstract

BACKGROUND: Caudal administration of levobupivacaine (2.5 mg/kg) in children is used frequently in some hospitals. However, no reports of levobupivacaine concentrations have been published with this dosing scheme. We report the results of a study on the pharmacokinetics of levobupivacaine (2.5 mg/kg) after caudal administration in children younger than 3 yr.

METHODS: Ten children, aged 1–36 mo and scheduled for subumbilical surgery were studied under sevoflurane anesthesia. After caudal injection of 0.25% levobupivacaine (2.5 mg/kg), serial venous blood samples were taken for 3 h to measure total plasma concentration levels of levobupivacaine. Median (range) levobupivacaine Cmax and Tmax measured were 1.48 (0.62–2.40) µg/mL and 37 (10–60) min. The highest individual Cmax was observed in a 1-mo-old infant 30 min after caudal block.

CONCLUSIONS: The highest Cmax reached in this study was close to the toxic threshold of adult patients. Although no adverse events have been reported, care must be taken, especially in small infants, after caudal administration of levobupivacaine (2.5 mg/kg).






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2008 by the International Anesthesia Research Society.