Document Detail


Serum bupivacaine concentrations and transplacental transfer following repeated epidural administrations in term parturients during labour.
MedLine Citation:
PMID:  9263767     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Bupivacaine is the most widely used local anaesthetic in obstetrics for epidural analgesia. Nineteen women (mean age 26.9 +/- 5.3 years) who underwent epidural analgesia during labour were included in this study. All parturients received a first injection of 21.8 +/- 2.5 mg 0.25% plain bupivacaine. The following administrations were given on request: 0.25% concentration was used when cervix uteri was supple, and a 0.375% concentration when it was tonic. Blood samples were collected 5 min after the first injection and then every 30 min until delivery. At delivery blood samples were collected from the infant umbilical cord vein and from the arm vein of the mother. Bupivacaine was assayed by high pressure liquid chromatography. Serum data were analyzed for each patient using a non-compartmental model. Bupivacaine was rapidly detected in serum, and maximal concentration was reached between 5 and 35 min. Pharmacokinetic parameters were estimated in 17 women after the first injection: 87 +/- 35 min for elimination half-life, 60 +/- 19 L for apparent volume of distribution and 0.5 +/- 0.3 L/min for plasmatic clearance. For a mean total duration of labour and total dose administered of respectively 222 +/- 115 min and 57.1 +/- 28.7 mg the mean value of the foeto-maternal ratio was 0.29 +/- 0.10. The infant maximal serum concentration was 0.26 microgram/mL. No side effects were spontaneously reported by the parturients and all infants had an Apgar score of 10 at 5 min after the delivery. We confirm the fast systemic absorption and rapid elimination of bupivacaine which may be used without risk of acute toxicity both in mother and child, even when it is used in a 0.375% concentration.
Authors:
G Decocq; M Brazier; L Hary; C Hubau; M R Fortaine; J Gondry; M Andréjak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Fundamental & clinical pharmacology     Volume:  11     ISSN:  0767-3981     ISO Abbreviation:  Fundam Clin Pharmacol     Publication Date:  1997  
Date Detail:
Created Date:  1997-09-24     Completed Date:  1997-09-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8710411     Medline TA:  Fundam Clin Pharmacol     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  365-70     Citation Subset:  IM    
Affiliation:
Service de Pharmacologie Clinique, CHU Hôpital sud, Amiens, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesia, Epidural
Analgesia, Obstetrical
Anesthetics, Local / administration & dosage,  blood*,  pharmacokinetics
Bupivacaine / administration & dosage,  blood*,  pharmacokinetics
Female
Humans
Injections, Epidural
Labor, Induced
Maternal-Fetal Exchange*
Pregnancy
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 2180-92-9/Bupivacaine

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