Anesthesia & Analgesia, Vol 82, 231-234, Copyright © 1996 by International Anesthesia Research Society
Bupivacaine plasma concentrations during continuous epidural anesthesia in infants and children
G Luz, P Innerhofer, B Bachmann, B Frischhut, G Menardi and A Benzer
Department of Anesthesia, University Hospital, Innsbruck, Austria.
Venous bupivacaine plasma concentrations were measured in six neonates and
infants aged 4 days to 3.9 mo (mean, 2.1 mo) and 10 infants and children
aged 9 mo to 6 yr (mean, 3.1 yr) after administration of an initial bolus
of 0.5 mL/kg bupivacaine 0.25%, followed by a continuous infusion of local
anesthetic (0.25 mL.kg-1.h-1) over a period of 4 h (first hour: bupivacaine
0.25%, then reduced to 0.125%). Plasma concentrations of local anesthetic
measured at 180 min and 300 min after beginning of bupivacaine
administration were significantly higher in younger infants when compared
to older infants and children (180 min: 0.67 +/- 0.24 micrograms/mL
[0.25-0.97] vs 0.27 +/- 0.11 micrograms/mL [0.19-0.55], P < 0.01; 300
min: 0.86 +/- 0.36 micrograms/mL [0.35-1.25] vs 0.34 +/- 0.12 micrograms/mL
[0.18-0.57], P < 0.01). The results of our study show that despite
applying the same dosage of epidural bupivacaine significantly higher
plasma concentrations were seen after short periods of continuous infusion
in infants up to 4 mo than in children older than 9 mo.