Related Experiment Video

Updated: Jul 22, 2026

Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds
04:58

Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds

Published on: October 20, 2012

Plasma bupivacaine concentrations in children during caudal epidural analgesia

R L Eyres, W Bishop, R C Oppenheim

    Anaesthesia and Intensive Care
    |February 1, 1983
    PubMed

    Insights

    This study measured plasma bupivacaine concentrations in children receiving caudal epidural analgesia. The results show bupivacaine levels remained safely below toxic limits, ensuring patient safety during pediatric pain management.

    Area of Science:

    • Pediatric Anesthesiology
    • Pharmacokinetics
    • Pain Management

    Background:

    • Caudal epidural analgesia is common for pediatric pain relief.
    • Understanding bupivacaine pharmacokinetics is crucial for safe administration.
    • Assessing plasma concentrations helps prevent local anesthetic systemic toxicity (LAST).

    Purpose of the Study:

    • To determine plasma bupivacaine concentrations in children after caudal epidural analgesia.
    • To evaluate the safety of 0.25% bupivacaine at a dose of 3 mg/kg in pediatric patients.
    • To investigate potential differences in arterial versus venous bupivacaine levels.

    Main Methods:

    • 45 children (4 months to 12 years) received caudal epidural analgesia with 0.25% bupivacaine (3 mg/kg).
    • Plasma bupivacaine concentrations were measured.
    • Simultaneous arterial and venous blood samples were collected for the first 15 minutes.

    Main Results:

    • Mean plasma bupivacaine concentrations ranged from 1.2-1.4 microgram/ml.
    • These levels were significantly below established toxic thresholds.
    • A small but significant difference was observed between arterial and venous sampling for 15 minutes.

    Conclusions:

    • Caudal epidural administration of 0.25% bupivacaine at 3 mg/kg is safe in children.
    • Plasma bupivacaine levels are within acceptable safety margins.
    • Arterial and venous sampling show minimal initial differences.

    More Related Videos

    Cavernous Nerve Stimulation and Recording of Intracavernous Pressure in a Rat07:43

    Cavernous Nerve Stimulation and Recording of Intracavernous Pressure in a Rat

    Published on: April 23, 2018

    Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia03:14

    Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

    Published on: January 31, 2025

    Related Concept Videos

    Local Anesthetics: Pharmacokinetics01:13

    Local Anesthetics: Pharmacokinetics

    The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
    Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

    Local Anesthetics: Clinical Application as Spinal Anesthesia

    Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
    Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

    Local Anesthetics: Clinical Application as Epidural Anesthesia

    Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
    Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
    Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

    Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

    Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
    One of the advantages of...
    Parenteral Anesthetics: Overview01:24

    Parenteral Anesthetics: Overview

    Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
    Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

    Pharmacokinetics in Pediatric Patients: Drug Distribution

    Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight, compared...