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Venous Blood Concentrations after Subarachnoid Administration of Bupivacaine

Axelsson K. H. MD PhD; Sundberg, A. E. A. MD; Edström, H. H. PhD; Widman, G. B. MD, PhD; Sjöstrand, U. H. MD, PhD
Anesthesia & Analgesia: July 1986

Peripheral venous blood concentrations of bupivacaine were measured in 51 patients given 0.5% (4 ml, 20 mg) or 0.75% (3 ml, 22.5 mg) bupivacaine, both solutions with or without glucose, for spinal anesthesia. The initial absorption of bupivacaine, as measured in peripheral venous blood, was rapid, although the blood concentrations were low. The mean peak concentration (Cmax) did not differ when glucose was added to 0.5 or 0.75% bupivacaine. When glucose-free and glucose-containing bupivacaine groups were combined, 22.5 mg bupivacaine give a significantly higher venous blood concentration than 20 mg of the solution. The mean time between subarachnoid injection and the time when Cmax was reached (tpeak) was influenced by the density of bupivacaine, i.e., the tpeak of bupivacaine with glucose was significantly shorter than with glucose-free solution (35 min; P < 0.05). No correlation was found between Cmax and the age, height, or weight of the patients, or between Cmax and the maximum cephalad level of analgesia in the different groups. In addition, there was no correlation between tpeak and the age, height, or weight of the patients. The maximal cephalad level of analgesia did not influence tpeak. in the different groups (the correlation coefficients < 0.3).

Address correspondence to Dr. Axelsson, Department of Anesthesiology and Intensive Care, Örebro Medical Center Hospital, S-701 85 Örebro, Sweden.

© 1986 International Anesthesia Research Society