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Blood Bupivacaine Concentrations After a Combined Single-Shot Sciatic Block and a Continuous Femoral Nerve Block in Pediatric Patients: A Prospective Observational Study

Suresh, Santhanam MD*; De Oliveira, Gildasio S. Jr MD, MSCI

doi: 10.1213/ANE.0000000000001531
Pediatric Anesthesiology: Brief Report

We evaluated blood bupivacaine concentrations in children having a single-shot sciatic and continuous femoral blocks after anterior cruciate ligament repair. Dried blood spot samples were analyzed for bupivacaine levels at 0, 5, 15, 30, 60, and 120 minutes and 4, 24, and 48 hours. The highest 99% upper confidence interval limit was 135 ng/mL at the 4-hour evaluation point. The 99% upper confidence interval was below potentially toxic levels (1500 ng/mL) across all sampling times. The risk of local anesthetic toxicity in pediatric patients receiving single-shot sciatic and continuous femoral nerve blocks is very low.

Published ahead of print August 31, 2016.

From the *Department of Anesthesiology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois; and Department of Anesthesiology, Northwestern University, Chicago, Illinois.

Published ahead of print August 31, 2016.

Accepted for publication June 27, 2016.

Funding: Ann & Robert H. Lurie Children’s Hospital of Chicago.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Gildasio S. De Oliveira, Jr, MD, MSCI, Department of Anesthesiology, Northwestern University, 241 E Huron St, F5-704, Chicago, IL. Address e-mail to g-jr@northwestern.edu.

© 2017 International Anesthesia Research Society
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