Pharmacokinetic and clinical effects of two bupivacaine concentrations on axillary brachial plexus block
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , |
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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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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1814268439645126656 |