Plasma concentrations of bupivacaine after intercostal nerve block in patients after orthotopic liver transplantation.
prospective_cohort · Level II
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Abstract
Bilateral intercostal nerve blocks were performed on 12 occasions in 11 patients after liver transplantation. Group 1 (six patients) received bupivacaine 2 mg kg-1 on one occasion; in group 2 (five patients) bupivacaine 2 mg kg-1 with adrenaline 1:200,000 was injected on two occasions separated by 6 h. Arterial blood was sampled repeatedly and analysed for total bupivacaine concentrations by high performance liquid chromatography (HPLC). Six patients had bupivacaine concentrations within the putative toxic threshold of 2-4 micrograms ml-1. The use of adrenaline-containing solutions neither slowed absorption reliably nor decreased peak concentrations of bupivacaine. Cumulation of bupivacaine occurred in group 2. No patient had adverse effects attributable to the bupivacaine.
Medical subject headings
- Bupivacaine
- Intercostal Nerves
- Liver Transplantation
- Nerve Block
- Thoracic Nerves