Pharmacokinetics of lidocaine after bilateral ESP block
Pharmacokinetics of lidocaine after bilateral ESP block
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DOI：
10.1136/rapm-2020-101718
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发表时间：
2021-01-01
影响因子：
5.1
通讯作者：
Munari, Marina
中科院分区：
文献类型：
--
作者：
De Cassai, Alessandro;Bonanno, Claudio;Munari, Marina
竖脊平面阻滞是一种新兴的界面阻滞，在围手术期镇痛和慢性疼痛治疗中具有广泛的适应症。近年来的研究主要集中在ESP阻滞的作用机制上。然而，到目前为止，注射到ESP中的药物的药代动力学尚未得到研究。本简短报告的目的是研究利多卡因在10例患者体内的药代动力学。方法我们报告了10例在多节段腰椎手术中接受双侧ESP阻滞的患者。以理想体重为基础，使用3.5 mg/kg的利多卡因进行ESP。利多卡因分别在5、15、30分钟和1、2、3小时给药。结果所有患者T-max均为5 min。C-max范围为1.2 ~ 3.8 mg/L（平均值为2.59 mg/L）。AUC（0-3）高（平均76%），表明几乎完全的生物利用度。年龄与利多卡因t1 /2呈负相关。结论利多卡因阻滞后的药代动力学表现为两室模型，具有快速和广泛的吸收速率。然而，其峰值浓度从未超过公认的毒性限度。消除半衰期略有延长，可能与部分患者年龄较大有关。
Introduction Erector spinae plane (ESP) block is an emerging interfascial block with a wide range of indications for perioperative analgesia and chronic pain treatment. Recent studies have focused their attention on mechanisms of action of ESP block. However, the pharmacokinetics of drugs injected in ESP is, as of now, uninvestigated. The aim of this brief report is to investigate the pharmacokinetics of lidocaine in a series of 10 patients.Methods We are reporting a case series of 10 patients undergoing bilateral ESP block for multilevel lumbar spine surgery. ESP was performed with 3.5 mg/kg of lidocaine based on ideal body weight. Lidocaine concentration was dosed at 5, 15, 30 min and at 1, 2 and 3 hours.Results T-max was 5 min for all the patients. C-max ranged from 1.2 to 3.8 mg/L (mean: 2.59 mg/L). AUC(0-3) was high (76%, on average) suggesting an almost complete bioavailability. Age had a negative correlation with T 1/2 of lidocaine.Conclusions Lidocaine pharmacokinetic after ESP block is well-described by a two-compartment model with a rapid and extensive rate of absorption. Nevertheless, its peak concentrations never exceeded the accepted toxicity limit. Elimination half-life was slightly prolonged, probably due to the advanced age of some patients.