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Pharmacokinetics of Interpleural Lidocaine Administration in Trauma Patients

Received from the Departments of Anesthesiology of Necker Hospital (Pr. Barrier), Université Paris V, Paris, and of Bicêtre Hospital, Université Paris Sud, Le Kremlin Bicêtre, France.

Abstract

Local anesthetics have been administered interpleurally for postoperative pain relief (1), and the phar-macokinetics involved have been studied in spontaneously breathing postoperative patients (2,3). Local anesthetics also have been used interpleurally for pain relief in patients with multiple rib fractures (4). These patients may have abnormal pharmacokinetics because they have sustained chest trauma, but there are no data to support or refute this hypothesis. Similarly, patients with multiple rib fractures are usually mechanically ventilated, but the effect of mechanical ventilation on the lidocaine pharmacokinetics after interpleural injection is not known. The aim of this study was to provide information on the effect of chest trauma and mechanical ventilation on the pharmacokinetics of interpleural lidocaine.

Key Words: ANESTHETIC TECHNIQUES, REGIONAL—interpleural. • ANESTHETICS, LOCAL—lidocaine. • PHARMACOKINETICS, LIDOCAINE—interpleural.