Pharmacokinetics of bupivacaine after bilateral ultrasound-guided transversus abdominis plane block following cesarean delivery under spinal anesthesia

Pharmacokinetics of levobupivacaine with epinephrine in transversus abdominis plane block for postoperative analgesia after Caesarean section

“…fraction in this population. 6,16,22 Considering the relatively low C max obtained, the absence of cases with LAST symptoms, and the good analgesic effect observed, in our opinion these results add new information to support the safety profile of this dose scheme and discourage the use of higher doses. Finally, to obtain a more comprehensive modelling analysis, we have pooled the data from two studies.…”

“…14,15 There is scarce information on levobupivacaine PK after a TAP block in pregnant patients to compare our results. A recent study by Trabelsi and colleagues 16 reported mean bupivacaine C max values of 0.802 mg L À1 (95% CI: 0.232e3.505 mg L À1 ) after bilateral TAP blocks (bupivacaine 50 mg each side) in post-Caesarean section patients. The mean value is very close to our mean levobupivacaine predicted concentration in male volunteers receiving a similar dose (0.84±0.38 mg L À1 ), and significantly higher than that predicted in pregnant patients (0.493±0.13 mg L À1 ).…”

Cytotoxicity of amide-linked local anesthetics on melanoma cells via inhibition of Ras and RhoA signaling independent of sodium channel blockade

“…1). The mean peak plasma concentrations of local anesthetics following transversus abdominis plane block is between 1 and 3 μM [26]. Similarly, Li et al's work referred 0.02 to 0.1 mM as clinical relevance doses of local anesthetics [27].…”

Bupivacaine Pharmacokinetics in Pregnant Women

“…The mean area under the curve (AUC) (0-24 h) was 4505.4 ng/mL, and the elimination half-life was 8.75 h for bupivacaine, demonstrating that bilateral blockade increases the total concentration of bupivacaine in the plasma after administering spinal anesthesia with bupivacaine. Plasma concentrations occurred at 30 min after injection, all peak concentrations were reached between 10 and 90 min and a second delayed peak of 90 min [10].…”

“…Bupivacaine has a pKa of 8.1, ionized fraction of 15% at a pH of 7.4, fat/buffer coefficient of 115, protein binding 95%, molecular weight of 288 Daltons, and an effective anesthetic concentration in the rat sciatic nerve of 0.25. The main determinant of adverse systemic effects is the free fraction, which is not bound to proteins [10].…”