Literature DB >> 15248626

The systemic absorption and disposition of levobupivacaine 0.5% after epidural administration in surgical patients: a stable-isotope study.

M J G Simon1, B T Veering, R Stienstra, J W van Kleef, S G P Williams, G M McGuire, A G L Burm.   

Abstract

BACKGROUND AND
OBJECTIVE: Absorption and disposition kinetics can be studied with a stable-isotope method. The aim of this study was to validate a stable-isotope method for levobupivacaine and to derive the relevant pharmacokinetics after epidural administration.
METHODS: Eight volunteers (18-32 yr) received approximately 23 mg of both levobupivacaine and deuterium-labelled levobupivacaine simultaneously by intravenous infusion. Venous blood samples were taken for 8 h. Fifteen patients (23-85 yr) received 19 mL levobupivacaine 0.5% (including a 3 mL test dose) epidurally and, 25 min later, approximately 25 mg deuterium-labelled levobupivacaine (D3-levobupivacaine) intravenously. Arterial blood samples were collected for 24 h. Plasma concentrations were determined using liquid chromatography-mass spectrometry. Plasma concentration-time data were analysed by compartmental and non-compartmental analysis.
RESULTS: Based on the ratio of the normalized areas under the curve of unlabelled and deuterium-labelled levobupivacaine in volunteers, as determined by both compartmental (mean ratio: 1.02, 90% CI: 1.00-1.04) and non-compartmental analysis (mean ratio: 1.02, 90% CI: 1.00-1.03) the two formulations were considered equivalent. In surgical patients the elimination half-life (mean +/- SD: 196 +/- 65 min), total body clearanc (349 +/- 114 mL min(-1)) and volume of distribution at steady state (56 +/- 14 L), derived by compartmental analysis, were similar to those obtained by non-compartmental analysis. The absorption was bi-phasic. The fractio absorbed and half-life of the fast absorption process were 0.22 +/- 0.06 and 5.2 +/- 2.7 min, respectively. Th values for the slow absorption process were 0.84 +/- 0.14 and 386 +/- 91 min, respectively.
CONCLUSIONS: D3-levobupivacaine is pharmacokinetically equivalent to unlabelled levobupivacaine and can be used to study the absorption and disposition kinetics after perineural administration of levobupivacaine in a single experiment.

Entities:  

Mesh:

Substances:

Year:  2004        PMID: 15248626     DOI: 10.1017/s0265021504006088

Source DB:  PubMed          Journal:  Eur J Anaesthesiol        ISSN: 0265-0215            Impact factor:   4.330


  6 in total

Review 1.  Levobupivacaine: a review of its use in regional anaesthesia and pain management.

Authors:  Mark Sanford; Gillian M Keating
Journal:  Drugs       Date:  2010-04-16       Impact factor: 9.546

Review 2.  Clinical Pharmacokinetics and Pharmacodynamics of Levobupivacaine.

Authors:  Chantal A A Heppolette; Derek Brunnen; Sohail Bampoe; Peter M Odor
Journal:  Clin Pharmacokinet       Date:  2020-06       Impact factor: 6.447

3.  Hemodynamic impact of isobaric levobupivacaine versus hyperbaric bupivacaine for subarachnoid anesthesia in patients aged 65 and older undergoing hip surgery.

Authors:  Rosa Herrera; Jose De Andrés; Luis Estañ; Francisco J Morales Olivas; Inocencia Martínez-Mir; Thorsten Steinfeldt
Journal:  BMC Anesthesiol       Date:  2014-10-24       Impact factor: 2.217

4.  Comparison of Three Different Concentrations of Levobupivacaine for Epidural Labor Analgesia: Clinical Effect and Pharmacokinetic Profile.

Authors:  Ahmed Mostafa El-Shaarawy; Mohamed S Asfour; Doaa A Rashwan; Mahmoud M Amer; Shahira F El-Menshawe; Mohammed H Elkomy
Journal:  Anesth Essays Res       Date:  2018 Jan-Mar

5.  Population pharmacokinetics of bupivacaine in combined lumbar and sciatic nerve block.

Authors:  Hanene Eljebari; Nadia Jebabli; Issam Salouage; Emna Gaies; Mohamed Lakhal; Mehdi Boussofara; Anis Klouz
Journal:  Indian J Pharmacol       Date:  2014 Mar-Apr       Impact factor: 1.200

6.  A Randomized Comparison of Plasma Levobupivacaine Concentrations Following Thoracic Epidural Analgesia and Subpleural Paravertebral Analgesia in Open Thoracic Surgery.

Authors:  Jan Matek; Stanislav Cernohorsky; Stanislav Trca; Zdenek Krska; David Hoskovec; Jan Bruthans; Martin Sima; Pavel Michalek
Journal:  J Clin Med       Date:  2020-05-09       Impact factor: 4.241

  6 in total

北京卡尤迪生物科技股份有限公司 © 2022-2023.