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Venous Blood Concentrations after Subarachnoid Administration of Bupivacaine

Department of Anesthesiology and Intensive Care, Örebro Medical Center Hospital, Örebro, Sweden.

Abstract

Peripheral venous blood concentrations of bupivacaine were measured in 51 patients given 0.5% (4 ml, 20 mg) or 0.75% (3 ml, 22.5 mg) bupivacaine, both solutions with or without glucose, for spinal anesthesia. The initial absorption of bupivacaine, as measured in peripheral venous blood, was rapid, although the blood concentrations were low. The mean peak concentration (C_max) did not differ when glucose was added to 0.5 or 0.75% bupivacaine. When glucose-free and glucose-containing bupivacaine groups were combined, 22.5 mg bupivacaine give a significantly higher venous blood concentration than 20 mg of the solution. The mean time between subarachnoid injection and the time when C_max was reached (t_peak) was influenced by the density of bupivacaine, i.e., the t_peak of bupivacaine with glucose was significantly shorter than with glucose-free solution (35 min; P < 0.05). No correlation was found between C_max and the age, height, or weight of the patients, or between C_max and the maximum cephalad level of analgesia in the different groups. In addition, there was no correlation between t_peak and the age, height, or weight of the patients. The maximal cephalad level of analgesia did not influence t_peak. in the different groups (the correlation coefficients < 0.3).

Key Words: ANESTHETIC TECHNIQUES—spinal • ANESTHETICS, LOCAL—bupivacaine

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