Levobupivacaine plasma concentrations following repeat caudal anesthetics.
anesthesia, caudal
infant
levobupivacaine
local anesthetic, toxicity
pharmacokinetics
Journal
Paediatric anaesthesia
ISSN: 1460-9592
Titre abrégé: Paediatr Anaesth
Pays: France
ID NLM: 9206575
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
revised:
01
09
2022
received:
30
07
2022
accepted:
09
09
2022
pubmed:
16
9
2022
medline:
15
11
2022
entrez:
15
9
2022
Statut:
ppublish
Résumé
A single caudal anesthetic at the start of lower abdominal surgery is unlikely to provide prolonged analgesia. A second caudal at the end of the procedure extends the analgesia duration but total plasma concentrations may be associated with toxicity. Our aim was to measure total plasma levobupivacaine concentrations after repeat caudal anesthesia in infants and to generate a pharmacokinetic model for prediction of plasma concentrations after repeat caudal anesthesia in neonates, infants and children. Infants undergoing definitive repair of anorectal malformations or Hirschsprung's disease received a second caudal anesthesia at the end of the procedure. Total levobupivacaine concentrations were assayed 3-4 times in the first 6 h after the initial caudal. These data were pooled with data from four studies describing plasma concentrations after levobupivacaine caudal or spinal anesthesia. Population pharmacokinetic parameters were estimated using nonlinear mixed-effects models. Covariates included postmenstrual age and body weight. Parameter estimates were used to simulate concentrations after a repeat levobupivacaine 2.5 mg kg Twenty-one infants (postnatal age 11-32 weeks, gestation 37-39 weeks, weight 5.2-8.6 kg) were included. The measured peak plasma concentration after repeat caudal levobupivacaine 2.5 mg kg Repeat caudal levobupivacaine 2.5 mg kg
Substances chimiques
Levobupivacaine
A5H73K9U3W
Bupivacaine
Y8335394RO
Anesthetics, Local
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1347-1354Informations de copyright
© 2022 John Wiley & Sons Ltd.
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