Pharmacokinetics and pharmacodynamics of 150 mg levobupivacaine with or without epinephrine for the treatment of sciatic-femoral nerve block
- VernacularTitle:150mg左布比卡因含或不含肾上腺素用于坐骨-股神经阻滞的药动学和药效学
- Author:
Ying CHEN
1
;
Jian ZHANG
;
Tianhua LIN
;
Lizhen YU
Author Information
1. 福建医科大学附属龙岩第一医院麻醉手术科
- Keywords:
Adrenaline;
Left bupivacaine;
Sciatic nerve;
Femoral nerve;
Pharmacokinetics;
Pharmacodynamics
- From:
China Modern Doctor
2018;56(13):33-36
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of epinephrine on the pharmacokinetics and pharmacodynamics of 150 mg levobupivacaine in patients with lower extremity surgery under ischial-femoral nerve block. Methods Forty patients with ASA I - Ⅱ undergoing elective ankle arthroplasty were randomLy divided into two groups including levobupivacaine group (L group), levobupivacaine combined with 1:200000 epinephrine group (LE group ), with 20 cases in each group. Under the guidance of ultrasound, the L group was treated with the sciatic nerve block and femoral nerve block by 15 mL 0. 5％ levobupivacaine (total 30 mL, 150 mg). The LE group was treated with the sciatic nerve block and femoral nerve block by 0. 5％ levobupivacaine combined with 1: 200000 epinephrine of 15mL (total 30 mL, 150 mg). 5 mL venous blood was collected immediately after the end of administration in the femoral nerve block and at 5, 15, 30, 45, 60, 120, 180, 360, 720 min after the end of administration. The concentration of levobupivacaine in plasma at each time point was detected by gas chromatography -mass spectrometry (GC-MS). Pharmacokinetic parameters were calculated using Kinetica 4. 4. 1 drug and statistical software. The onset and duration of nerve block was evaluated. Results At 15 and 30 minutes, the levobupivacaine concentration in LE group was lower than that in L group(P＜0. 05). The peak plasma concentration of levobupivacaine in LE group was lower than that in L group (P＜0. 01). There was no significant difference in the other pharmacokinetic parameters between the two groups (P＞0. 05). There was no significant difference in the onset time and the maintenance time of nerve block between the two groups (尸＞0. 05). Conclusion Epinephrine can reduce Cmax of plasma levobupivacaine in 150 mg levobupivacaine -induced ischial -femoral nerve block, but has no effect on the onset and maintenance of nerve block.
