Linked Life Data

6668096

Source:http://linkedlifedata.com/resource/pubmed/id/6668096

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
12
pubmed:dateCreated
1984-4-16
pubmed:abstractText
The pharmacokinetic parameters for 50 patients undergoing continuous extravascular perineural bupivacaine infusions for the treatment of their chronic pain were studied. The total plasma clearance (CL), volume of distribution (Vz), and elimination rate (lambda z) were estimated from two blood samples. These parameters were compared to values obtained from the actual mono-exponential decay curve at the termination of infusion. Estimated and actual pharmacokinetic parameters were found to be in excellent agreement. No evidence of accumulation was seen even after 5 days of continuous infusion. Steady states (Css) were found to be independent of the infusion site. This study demonstrates a wide margin of safety during continuous perineural bupivacaine infusions at dosages used in our study, e.g., up to 30 mg/h in normal patients. Such patients do not require determination of serum bupivacaine concentration to monitor the changes in dosages necessary for adequate clinical effect. On the other hand, in patients with renal or hepatic dysfunction, altered clearance rates are expected. In such patients, monitoring of serum bupivacaine concentrations is necessary to determine the range of dosages available for adjustment to provide adequate clinical effect and prevent systemic toxicity. This study demonstrates that two blood samples drawn at 3-5 h after the start of infusion and at steady state are sufficient to accurately determine the clearance rate for a patient. Safe management is then possible using this clearance to calculate the range of dosages permissible for that patient during continuous perineural infusion. Steady-state concentrations estimated from clearances were found to be in excellent agreement with the steady-state concentrations actually measured for a given infusion rate.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
0174-4879
pubmed:author
pubmed:issnType
Print
pubmed:volume
21
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
591-7
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:year
1983
pubmed:articleTitle
Continuous perineural infusion of bupivacaine for prolonged analgesia: pharmacokinetic considerations.
pubmed:publicationType
Journal Article, Comparative Study, Research Support, Non-U.S. Gov't