Biomaterial Database

[Plasma levels of ropivacaine and bupivacaine during postoperative patient controlled thoracic epidural analgesia]. 2003

A Gottschalk, and M-A Burmeister, and M Freitag, and C Böhme, and T Standl

Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf. gottschalk.andre@gmx.de

BACKGROUND The postoperative continuous epidural application of local anesthetics can cause side effects like motor blockade and systemic intoxication. The study was performed to evaluate the plasma levels of two local anesthetics and their analgesic and side effects in continuous postoperative epidural analgesia. METHODS In a prospective, randomized and double-blind study we have compared side effects of ropivacaine 0.375% (group R) vs. bupivacaine 0.125% in combination with sufentanil 0.5 microg ml(-1) (group B/S) via thoracic epidural catheters for a duration of 96 hours after major abdominal surgery in 30 gynaecological tumor patients. Analgesic effects, side effects and plasma levels of the respective local anesthetic were measured 24, 48, 72 and 96 h after start of epidural infusion. RESULTS No differences were seen in demographics, perioperative data and analgesic effects. The following cumulative doses of local anesthetics were applied (Group R vs. B/S (median/minimum-maximum ml)): 24 h: 151/121-225 vs. 141/83-171; 48 h: 311/237-424 vs. 299/184-497; 72 h: 454/366-566 vs. 440/256-598; 96 h: 572/399-859 vs. 568/284-711. Plasma levels of local anesthetics remained far below the toxic threshold of 0.6 micro g/ml (Group R vs. B/S (median/minimum-maximum micro g/ml): 24 h: 0.05/0.03-0.24 vs. 0.0/0.0-0.02; 48 h: 0.06/0.02-0.15 vs. 0.006/0.0-0.02; 72 h: 0.05/0.0-0.11 vs. 0.0/0.0-0.02; 96 h: 0.02/0.01-0.32 vs. 0.0/0.0-0.01). The incidence and intensity of motor block (Bromage scale) and other side effects did also not differ between groups. CONCLUSIONS The present study shows that thoracic epidural infusion with bupivacaine 0.125% and with a higher concentration of ropivacaine 0.375% during 96 h provides plasma levels of unbound local anesthetic far below the toxic threshold.

UI	MeSH Term	Description	Entries
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010149	Pain, Postoperative	Pain during the period after surgery.	Acute Post-operative Pain,Acute Postoperative Pain,Chronic Post-operative Pain,Chronic Post-surgical Pain,Chronic Postoperative Pain,Chronic Postsurgical Pain,Pain, Post-operative,Persistent Postsurgical Pain,Post-operative Pain,Post-operative Pain, Acute,Post-operative Pain, Chronic,Post-surgical Pain,Postoperative Pain, Acute,Postoperative Pain, Chronic,Postsurgical Pain,Postoperative Pain,Acute Post operative Pain,Chronic Post operative Pain,Chronic Post surgical Pain,Chronic Postsurgical Pains,Pain, Acute Post-operative,Pain, Acute Postoperative,Pain, Chronic Post-operative,Pain, Chronic Post-surgical,Pain, Chronic Postoperative,Pain, Chronic Postsurgical,Pain, Persistent Postsurgical,Pain, Post operative,Pain, Post-surgical,Pain, Postsurgical,Post operative Pain,Post operative Pain, Acute,Post operative Pain, Chronic,Post surgical Pain,Post-operative Pains,Post-surgical Pain, Chronic,Postsurgical Pain, Chronic,Postsurgical Pain, Persistent
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D002045	Bupivacaine	A widely used local anesthetic agent.	1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D004305	Dose-Response Relationship, Drug	The relationship between the dose of an administered drug and the response of the organism to the drug.	Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004311	Double-Blind Method	A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.	Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077212	Ropivacaine	An anilide used as a long-acting local anesthetic. It has a differential blocking effect on sensory and motor neurons.	1-Propyl-2',6'-pipecoloxylidide,AL 381,AL-381,LEA 103,LEA-103,Naropeine,Naropin,Ropivacaine Hydrochloride,Ropivacaine Monohydrochloride,Ropivacaine Monohydrochloride, (S)-isomer,1 Propyl 2',6' pipecoloxylidide,AL381,LEA103
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults