Plasma Concentrations of Local Anaesthetics After Interscalene Brachial Plexus Block

Wildsmith, J.A.W.; Tucker, GT; Cooper, Stephanie; Scott, D.B.; Covino, Benjamín G.

doi:10.1097/00132586-197804000-00046

Cited by 8 publications

(11 citation statements)

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“…In addition, the results of this study (in which many patients had rheumatoid arthritis) are similar to those found by Wildsmith and colleagues [1] in a much younger and healthier population. There was no evidence to suggest a greater risk of toxicity in patients with rheumatoid disease.…”

Section: Discussionsupporting

confidence: 90%

“…The range of results was wide (as shown in table III), and one patient in the interscalene group developed a peak concentration of 10.94 |ig ml" 1 . The timing of this does not suggest i.v.…”

Section: Discussionmentioning

confidence: 91%

“…Where comparisons can be made with the results of a study in which a number of drugs were injected by the inter scalene technique, there is a suggestion that this method results in higher systemic concentrations than others [1]. Therefore, a study was devised to allow comparison of the systemic concentrations produced by three different techniques of brachial plexus blockade.…”

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confidence: 99%

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Plasma Prilocaine Concentrations After Three Techniques of Brachial Plexus Blockade

MacLean

Chambers

Tucker

et al. 1988

British Journal of Anaesthesia

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Although a number of specific techniques have been described, injection of local anaesthetic to the brachial plexus is performed essentially in three areas: between the scalene muscles, over the first rib, and in the axilla. Injection at each of these points produces blocks which vary in distribution, but every technique requires a relatively large dose of local anaesthetic. Thus knowledge of the systemic drug concentrations which are likely to result is essential.Most previous work has considered the effects of using one drug for one particular technique. Where comparisons can be made with the results of a study in which a number of drugs were injected by the inter scalene technique, there is a suggestion that this method results in higher systemic concentrations than others [1]. Therefore, a study was devised to allow comparison of the systemic concentrations produced by three different techniques of brachial plexus blockade. PATIENTS AND METHODSPatients (ASA I-III) who were to undergo hand or wrist operations under brachial plexus blockade gave informed consent for the study. After an overnight fast and premedication with diazepam 10 mg by mouth, the patient was transferred to the operating theatre and a cannula placed in a vein in the contralateral antecubital fossa for blood sampling. A control sample (time 0) was taken.Patients were allocated to receive 15% plain prilocaine 35 ml by the interscalene, subclavian perivascular, or axillary techniques [2]. The interscalene route was not used in those patients undergoing surgery predominantly of the ulnar side of the hand. Blood samples were taken into lithium-heparin tubes at 5, 10, 15, 20, 25, 30, 45 and 60 min after the end of the injection and were centrifuged and die plasma withdrawn and frozen in plain tubes pending subsequent analysis. Prilocaine concentrations were measured by high performance liquid chromatography (HPLC). Thirty minutes after the injection, supplementary nerve blocks using lignocaine were performed, as necessary; i.v. sedation was given if needed, and surgery commenced. Measurement of prilocaine concentration (HPLC)Plasma 0.25 ml, internal standard solution (ethylmethylglycinexylidide) 50 ulitre, 100 ng ml-1 , NaOH 200 ulitre, il mol litre" 1 and diethylether 5 ml were vortexed (1 min), centrifuged (5 min, 3000 rev min~l) and the ether layer transferred to a conical tube. After evaporation to dryness at 35 °C, the residue was reconstituted in 200 ulitre of mobile phase (12:88 acetonitrile/ water plus triethylamine/orthophosphric acid to pH 3.0) and injected to a Novopac column within a Z-module (Waters Ltd) and widi a C-18 GuardDownloaded from https://academic.oup.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

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Plasma Prilocaine Concentrations After Three Techniques of Brachial Plexus Blockade

MacLean

Chambers

Tucker

et al. 1988

British Journal of Anaesthesia

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“…Prilocaine is hydrolyzed to hydrolyse to o-toluidine (OT) and Npropylalanine by the help of amidases enzymes. The main reason of methaemoglobinemia is taking overdose of prilocaine (exceeding 600 mg in adults or 8 mg kg -1 in children) which increases the concentration of o-toluidine [3][4][5] . In newborn infants, this enzyme, methaemoglobin, is not complete its development.…”

Section: Fig 1: Chemical Structure Of Prilocaine Hclmentioning

confidence: 99%

“…The stock standard solution of prilocaine HCl was prepared and stored at -20 o C under refrigeration. The six standard solutions (3,5,8,10,12, 15 μg/mL) in methanol were prepared by doing required dilutions from stock solution. Three quality control (QC) samples at the concentrations of 5, 8 and 10 μg/mL were prepared from the stock standard solution.…”

Section: Preparation Of the Standard And Quality Controlmentioning

confidence: 99%

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2012

IJPSR

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A simple and sensitive spectrophotometric method was developed for the determination of prilocaine HCl in pharmaceutical preparation and human plasma. The quantitative analysis of prilocaine HCl was carried out using of wavelength at 230 nm. The method was linear in concentration range of 3-15 μg/mL for standard solution and 4-15 μg/mL for human plasma. Linearity was determined by calculating correlation coefficient. These values were found as a 0.9999 and 0.9967 in standard solution and human plasma, respectively. Developed spectrophotometric method was found suitable in terms of accuracy, sensitivity, precision, reproducibility. In addition to these, this method could be easily and directly applied to both human plasma and pharmaceutical preparation. INTRODUCTION:The reason of using local anesthetics is to block the conduction of impulses in nerve fibers which cause anesthesia. They are most commonly used in dentistry and minor surgery in order to provide temporary relief of pain. There are two application types of local anesthetics which are topical and parenteral applications that reversibly block the nerve conductances.

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