Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block

Detalhes bibliográficos
Autor(a) principal: Ferraro, Leonardo Henrique Cunha [UNIFESP]
Data de Publicação: 2018
Outros Autores: Takeda, Alexandre [UNIFESP], Barreto, Cleber N. [UNIFESP], Faria, Bernadete [UNIFESP], Assunção, Nilson Antonio [UNIFESP]
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000200115&lng=en&nrm=iso&tlng=en&ORIGINALLANG=en
https://repositorio.unifesp.br/handle/11600/55927
Resumo: Introduction: The risk of systemic bupivacaine toxicity is a persistent problem, which makes its pharmacokinetic study fundamental for regional anesthesia safety. There is little evidence of its influence on plasma peak at different concentrations. The present study compares two bupivacaine concentrations to establish how the concentration affects this drug plasma peak in axillary brachial plexus block. Postoperative latency and analgesia were also compared. Methods: 30 patients were randomized. In the 0.25% Group, 0.25% bupivacaine (10 mL) was injected per nerve. In the 0.5% Group, 0.5% bupivacaine (5 mL) was injected per nerve. Peripheral blood samples were collected during the first 2 hours after the blockade. For sample analyses, high performance liquid chromatography mass spectrometry was used. Results: Plasma peak occurred 45 minutes after the blockade, with no difference between groups at the assessed time-points. Plasma peak was 933.97 +/- 328.03 ng.mL(-1) (mean +/- SD) in 0.25% Group and 1022.79 +/- 253.81 ng.mL(-1) in 0.5% Group (p = 0.414). Latency was lower in 0.5% Group than in 0.25% Group (10.67 +/- 3.71 x 17.33min +/- 5.30, respectively, p = 0.004). No patient had pain within the first 4 hours after the blockade. Conclusion: For axillary brachial plexus block, there was no difference in bupivacaine plasma peak despite the use of different concentrations with the same local anesthetic mass. The concentration inversely influenced latency. (C) 2017 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Anestesiologia.
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spelling Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus blockEfeitos farmacocinéticos e clínicos de duas concentrações de bupivacaína no bloqueio do plexo braquial via axilarBupivacaineBrachial plexusPharmacokineticsRegional anesthesiaBupivacaínaPlexo braquialFarmacocinéticaAnestesia regionalIntroduction: The risk of systemic bupivacaine toxicity is a persistent problem, which makes its pharmacokinetic study fundamental for regional anesthesia safety. There is little evidence of its influence on plasma peak at different concentrations. The present study compares two bupivacaine concentrations to establish how the concentration affects this drug plasma peak in axillary brachial plexus block. Postoperative latency and analgesia were also compared. Methods: 30 patients were randomized. In the 0.25% Group, 0.25% bupivacaine (10 mL) was injected per nerve. In the 0.5% Group, 0.5% bupivacaine (5 mL) was injected per nerve. Peripheral blood samples were collected during the first 2 hours after the blockade. For sample analyses, high performance liquid chromatography mass spectrometry was used. Results: Plasma peak occurred 45 minutes after the blockade, with no difference between groups at the assessed time-points. Plasma peak was 933.97 +/- 328.03 ng.mL(-1) (mean +/- SD) in 0.25% Group and 1022.79 +/- 253.81 ng.mL(-1) in 0.5% Group (p = 0.414). Latency was lower in 0.5% Group than in 0.25% Group (10.67 +/- 3.71 x 17.33min +/- 5.30, respectively, p = 0.004). No patient had pain within the first 4 hours after the blockade. Conclusion: For axillary brachial plexus block, there was no difference in bupivacaine plasma peak despite the use of different concentrations with the same local anesthetic mass. The concentration inversely influenced latency. (C) 2017 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Anestesiologia.Introdução: O risco de intoxicação sistêmica pelo uso da bupivacaína é um problema persistente e torna seu estudo farmacocinético fundamental para a segurança da anestesia regional. São escassas as evidências sobre a influência de diferentes concentrações no pico plasmático desse fármaco. O presente estudo compara duas concentrações de bupivacaína para estabelecer como a concentração afeta o pico plasmático desse fármaco no bloqueio do plexo braquial via axilar. Também se compararam latência e analgesia pós-operatória. Métodos: Foram randomizados 30 pacientes. No Grupo 0,25%, injetaram-se 10 mL de bupivacaína 0,25% por nervo. No Grupo 0,5%, injetaram-se 5 mL de bupivacaína 0,5% por nervo. Amostras de sangue periférico foram colhidas durante as duas primeiras horas após o bloqueio. Para análise das amostras, usou-se a cromatografia líquida de alta frequência acoplada ao espectrômetro de massas. Resultados: O pico plasmático ocorreu 45 minutos após o bloqueio, sem diferença entre os grupos nos tempos avaliados. O pico plasmático (média ± DP) foi 933,97 ± 328,03 ng.mL−1 no Grupo 0,25% e 1.022,79 ± 253,81 ng.mL−1 no Grupo 0,5% (p = 0,414). O Grupo 0,5% apresentou menor latência com relação ao Grupo 0,25% (10,67 ± 3,71 × 17,33 min ± 5,30; respectivamente; p = 0,004). Nenhum paciente apresentou dor nas primeiras quatro horas após o bloqueio. Conclusão: Para o bloqueio do plexo braquial via axilar, não foi detectada diferença no pico plasmático de bupivacaína apesar do uso de diferentes concentrações, com a mesma massa de anestésico local. A concentração influenciou inversamente a latência.Univ Fed Sao Paulo Unifesp, Disciplina Anestesiol Dor & Terapia Intens, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Inst Ciencias Ambientais Quim & Farmaceut, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Disciplina Anestesiol Dor & Terapia Intens, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Inst Ciencias Ambientais Quim & Farmaceut, Sao Paulo, SP, BrazilWeb of ScienceElsevier Science Inc2020-07-20T16:31:23Z2020-07-20T16:31:23Z2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion115-121application/pdfapplication/pdfhttp://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000200115&lng=en&nrm=iso&tlng=en&ORIGINALLANG=enRevista Brasileira De Anestesiologia. New York, v. 68, n. 2, p. 115-121, 2018.10.1016/j.bjan.7017.09.001S0034-70942018000200115-en.pdfS0034-70942018000200115-pt.pdf0034-7094https://repositorio.unifesp.br/handle/11600/55927WOS:000426733600001engRevista Brasileira De AnestesiologiaNew Yorkinfo:eu-repo/semantics/openAccessFerraro, Leonardo Henrique Cunha [UNIFESP]Takeda, Alexandre [UNIFESP]Barreto, Cleber N. [UNIFESP]Faria, Bernadete [UNIFESP]Assunção, Nilson Antonio [UNIFESP]reponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-03T08:37:40Zoai:repositorio.unifesp.br/:11600/55927Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-03T08:37:40Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block
Efeitos farmacocinéticos e clínicos de duas concentrações de bupivacaína no bloqueio do plexo braquial via axilar
title Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block
spellingShingle Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block
Ferraro, Leonardo Henrique Cunha [UNIFESP]
Bupivacaine
Brachial plexus
Pharmacokinetics
Regional anesthesia
Bupivacaína
Plexo braquial
Farmacocinética
Anestesia regional
title_short Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block
title_full Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block
title_fullStr Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block
title_full_unstemmed Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block
title_sort Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block
author Ferraro, Leonardo Henrique Cunha [UNIFESP]
author_facet Ferraro, Leonardo Henrique Cunha [UNIFESP]
Takeda, Alexandre [UNIFESP]
Barreto, Cleber N. [UNIFESP]
Faria, Bernadete [UNIFESP]
Assunção, Nilson Antonio [UNIFESP]
author_role author
author2 Takeda, Alexandre [UNIFESP]
Barreto, Cleber N. [UNIFESP]
Faria, Bernadete [UNIFESP]
Assunção, Nilson Antonio [UNIFESP]
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Ferraro, Leonardo Henrique Cunha [UNIFESP]
Takeda, Alexandre [UNIFESP]
Barreto, Cleber N. [UNIFESP]
Faria, Bernadete [UNIFESP]
Assunção, Nilson Antonio [UNIFESP]
dc.subject.por.fl_str_mv Bupivacaine
Brachial plexus
Pharmacokinetics
Regional anesthesia
Bupivacaína
Plexo braquial
Farmacocinética
Anestesia regional
topic Bupivacaine
Brachial plexus
Pharmacokinetics
Regional anesthesia
Bupivacaína
Plexo braquial
Farmacocinética
Anestesia regional
description Introduction: The risk of systemic bupivacaine toxicity is a persistent problem, which makes its pharmacokinetic study fundamental for regional anesthesia safety. There is little evidence of its influence on plasma peak at different concentrations. The present study compares two bupivacaine concentrations to establish how the concentration affects this drug plasma peak in axillary brachial plexus block. Postoperative latency and analgesia were also compared. Methods: 30 patients were randomized. In the 0.25% Group, 0.25% bupivacaine (10 mL) was injected per nerve. In the 0.5% Group, 0.5% bupivacaine (5 mL) was injected per nerve. Peripheral blood samples were collected during the first 2 hours after the blockade. For sample analyses, high performance liquid chromatography mass spectrometry was used. Results: Plasma peak occurred 45 minutes after the blockade, with no difference between groups at the assessed time-points. Plasma peak was 933.97 +/- 328.03 ng.mL(-1) (mean +/- SD) in 0.25% Group and 1022.79 +/- 253.81 ng.mL(-1) in 0.5% Group (p = 0.414). Latency was lower in 0.5% Group than in 0.25% Group (10.67 +/- 3.71 x 17.33min +/- 5.30, respectively, p = 0.004). No patient had pain within the first 4 hours after the blockade. Conclusion: For axillary brachial plexus block, there was no difference in bupivacaine plasma peak despite the use of different concentrations with the same local anesthetic mass. The concentration inversely influenced latency. (C) 2017 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Anestesiologia.
publishDate 2018
dc.date.none.fl_str_mv 2018
2020-07-20T16:31:23Z
2020-07-20T16:31:23Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000200115&lng=en&nrm=iso&tlng=en&ORIGINALLANG=en
Revista Brasileira De Anestesiologia. New York, v. 68, n. 2, p. 115-121, 2018.
10.1016/j.bjan.7017.09.001
S0034-70942018000200115-en.pdf
S0034-70942018000200115-pt.pdf
0034-7094
https://repositorio.unifesp.br/handle/11600/55927
WOS:000426733600001
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000200115&lng=en&nrm=iso&tlng=en&ORIGINALLANG=en
https://repositorio.unifesp.br/handle/11600/55927
identifier_str_mv Revista Brasileira De Anestesiologia. New York, v. 68, n. 2, p. 115-121, 2018.
10.1016/j.bjan.7017.09.001
S0034-70942018000200115-en.pdf
S0034-70942018000200115-pt.pdf
0034-7094
WOS:000426733600001
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Revista Brasileira De Anestesiologia
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 115-121
application/pdf
application/pdf
dc.coverage.none.fl_str_mv New York
dc.publisher.none.fl_str_mv Elsevier Science Inc
publisher.none.fl_str_mv Elsevier Science Inc
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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