Bupivacaine concentrations in the lumbar cerebrospinal fluid of patients during spinal anaesthesia.

Détails

ID Serval
serval:BIB_0DBA3A8557AF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Bupivacaine concentrations in the lumbar cerebrospinal fluid of patients during spinal anaesthesia.
Périodique
British Journal of Anaesthesia
Auteur(s)
Ruppen W., Steiner L.A., Drewe J., Hauenstein L., Brugger S., Seeberger M.D.
ISSN
1471-6771[electronic]
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
102
Numéro
6
Pages
832-838
Langue
anglais
Résumé
BACKGROUND: Data on bupivacaine concentrations in the cerebral spinal fluid (CSF) during spinal anaesthesia are scarce. The purpose of this study was to determine the concentration of bupivacaine in the lumbar CSF of patients with an adequate level of spinal anaesthesia after injection of plain bupivacaine 0.5%. METHODS: Sixty patients with an adequate level of spinal block after standardized administration of plain bupivacaine 20 mg in men and of 17.5 mg in women were studied. To measure the CSF bupivacaine concentration, we performed a second lumbar spinal puncture and obtained a CSF sample at a randomized time point 5-45 min after the bupivacaine injection. In addition, we calculated the half-life of bupivacaine in the CSF and tested the hypothesis that the level of spinal block is related to the lumbar CSF bupivacaine concentration. RESULTS: Men and women had CSF bupivacaine concentrations ranging from 95.4 to 773.0 microg ml(-1) (median 242.4 microg ml(-1)) and from 25.9 to 781.0 microg ml(-1) (median 187.6 microg ml(-1)), respectively. The large variability of bupivacaine concentrations obtained at similar times after subarachnoid administration made calculation of a meaningful half-life of bupivacaine in CSF impossible. There was no association between CSF bupivacaine concentration and spinal block level, and CSF bupivacaine concentrations for the same spinal block level differed between patients by six-fold. CONCLUSIONS: There is a large variability of CSF bupivacaine concentrations in patients with an adequate level of spinal anaesthesia.
Mots-clé
Aged, Anesthesia, Spinal/methods, Anesthetics, Local/cerebrospinal fluid, Bupivacaine/cerebrospinal fluid, Chromatography, High Pressure Liquid/methods, Female, Half-Life, Humans, Lumbosacral Region, Male, Middle Aged, Movement/physiology, Posture/physiology, Sensation/drug effects, Sex Factors, Spinal Puncture
Pubmed
Web of science
Création de la notice
08/12/2009 12:52
Dernière modification de la notice
03/03/2018 13:40
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