Plasma concentrations of bupivacaine after wound infiltration of an 0.5% solution after inguinal herniorrhaphy: a preliminary study

Abstract

After routine inguinal herniorrhaphy we gave 12 patients a wound infiltration regimen of bolus doses of 20 ml of 0.5% bupivacaine via a catheter within the wound and rectally administered indomethacin (100 mg). Peak venous plasma bupivacaine concentrations ranged from 0.07 mg.l-1 to 1.14 mg.l-1 (mean (SD) 0.47 (0.33) mg.l-1), and occurred at between 0.25 and 2 h after the first dose. Plasma concentrations were well below the toxic threshold of 4 mg.l-1 and there was no accumulation. The regimen provided satisfactory analgesia. There were no wound infections nor signs of toxicity.

Analgesia following appendicectomy — the value of peritoneal bupi-vacaine

“…A recent study examining bolus delivery of 20 ml bupivacaine 0.5% by wound infiltration demonstrated plasma concentrations well below the toxic threshold and a slower increase to peak plasma concentrations than the peritoneal route. 26 The doses employed in this study were below those used by Scheinin et alf1-3 and only half of the dose was given to the peritoneum. While the volume of solution given may appear large, the dose was well within the toxic limits of bupivacaine.…”

Incisional and epidural analgesia after caesarean delivery: a prospective, placebo-controlled, randomised clinical study

“…The peak venous concentrations in both groups were in the range normally measured in clinical settings and well below toxic levels. 11,[16][17][18][19] If used incautiously, however, repeated administrations of local anaesthetics may lead to accumulation for 4-7 half lives, and possibly induce adverse effects of systemic absorption. Some safety concerns about the balloon pump used in incisional analgesia have been reported.…”

L’auto-administration de bupivacaïne ou de ropivacaïne au site d’incision procure une analgésie efficace a la suite d’une herniorraphie inguinale

“…Analgesia in both cases was long lasting: the patient in Group B needed no other medication for 24 hr, while the patient from Group R took the rescue medication once. We did not measure blood levels of the LA; however, all plasma levels reported in the literature 8,9,14 after even higher doses of B (repeated administrations of 20 mL of 0.5% B) 14 or R (30 mL, 40 mL, 50 mL of 0.75% R) 8,9 did not show toxic levels of LA.…”