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Plasma Concentrations of Bupivacaine in Celiac Plexus Block
  1. Hinnerk Wulf, M.D.,
  2. Martin Gleim, M.D.,
  3. Christoph Maier, M.D. and
  4. Sabine Schulzeck, M.D.
  1. Department of Anesthesiology and Intensive Care Medicine, University Hospital of Kiel, Germany
  1. Reprint requests: Priv. Dot. Dr. med. Hinnerk Wulf, Department of Anesthesiology and Intensive Care Medicine, University Hospital, Schwanenweg 21, D 24105 Kiel, Germany.

Abstract

Background and Objectives. Following stellate ganglion block, systemic absorption of local anesthetics is rapid. Pharmacokinetic data for local anesthetics following other blocks, such as celiac plexus blocks, are lacking.

Methods. Plasma concentrations of bupivacaine in venous blood samples following celiac blocks were measured in 10 patients using a high-performance liquid chromatography technique; 40 mL plain bupivacaine 0.25% was administered.

Results. Celiac plexus block resulted in maximum plasma concentrations of 0.7-2.5 mg/L bupivacaine (mean, 1.5 ± 0.6 mg/L). In 3 of 10 patients plasma concentrations above 2 mg/L occurred. The maximum concentrations were reached 10-30 minutes after the injection (17 ± 8 minutes). No clinical signs of central nervous system toxicity occurred. All patients showed hemodynamic stability following the blocks.

Conclusions. Maximum plasma concentrations of bupivacaine occur rather late following celiac blocks compared to stellate ganglion or intercostal blocks. The rather high plasma concentrations of bupivacaine indicate the need for appropriate clinical monitoring.

  • regional anesthetic techniques
  • celiac plexus block
  • local anesthetics
  • bupivacaine
  • plasma concentration
  • protein binding

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Footnotes

  • The work was done at the Pain Clinic of the Department of Anesthesiology and Intensive Care Medicine and the Institute of Pharmacology, University Hospital of Kiel, Germany.

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