Pharmacokinetic Profile of Plasma Levobupivacaine Following Fascia Iliaca Compartment Block for Proximal Femoral Fracture in Older Patients

Rebecca Parr; Hal Robinson; Gary Cameron; Gillian Broadbent; Heather Wallace; Thomas  Engelhardt

Pharmacokinetic Profile of Plasma Levobupivacaine Following Fascia Iliaca Compartment Block for Proximal Femoral Fracture in Older Patients

Rebecca Parr^* (Corresponding Author), Hal Robinson, Gary Cameron, Gillian Broadbent, Heather Wallace, Thomas Engelhardt

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Introduction: Fascia iliaca compartment block (FICB) is commonly used in older patients to provide effective analgesia following hip fracture. However, only limited pharmacokinetic (PK) data about levobupivacaine are available to help clinical practice and establish safe volumes and amounts of local anesthetics.
Methods: Ten patients aged between 53 and 87 years, who underwent hemiarthroplasty following femoral neck fracture were recruited into this study. A fixed volume (40 mL) of 0.25% levobupivacaine was injected before the induction of anesthesia using ultrasound guidance. Venous blood samples were obtained at 0, 10, 20, 30, 45, 60, 75, 90, and 120 min time points and analyzed using mass spectrometry.
Results: The median (interquartile range) maximum observed plasma concentration (Cmax) of levobupivacaine was 0.48 (0.45-0.61) µg/mL, with the time to reach Cmax (tmax) of 38 minutes (30–105) after administration, a half-life of 2.8 h (1.65–5.8), and clearance rate of 0.72 L/min (0.36–1.26). The fixed volume (40 mL) of 0.25% levobupivacaine FICB did not exceed the recognized toxic threshold in adults (2.6 µg/mL).
Conclusion: The data described here indicate a similar levobupivacaine PK profile for older patients undergoing FICB for hip arthroplasty compared with the levobupivacaine PK profile for the general population.

Original language	English
Pages (from-to)	151-156
Number of pages	16
Journal	Pharmaceutical and Biomedical Research
Volume	6
Issue number	2
Early online date	15 Jun 2020
Publication status	Published - Jun 2020

Bibliographical note

This article was extracted from the PhD. thesis of Rebecca Parr in Scotia Biologics Ltd. LC-MS/MS.

Keywords

Pharmacokinetics
Levobupivacaine
Local anesthetic systemic toxicity (LAST)
Liquid chromatography with tandem mass spectrometry (LC-MS/MS)

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Cite this

@article{bbed3e27cb9f4384ba7dfd9ccfa1abc9,

title = "Pharmacokinetic Profile of Plasma Levobupivacaine Following Fascia Iliaca Compartment Block for Proximal Femoral Fracture in Older Patients",

abstract = "Introduction: Fascia iliaca compartment block (FICB) is commonly used in older patients to provide effective analgesia following hip fracture. However, only limited pharmacokinetic (PK) data about levobupivacaine are available to help clinical practice and establish safe volumes and amounts of local anesthetics.Methods: Ten patients aged between 53 and 87 years, who underwent hemiarthroplasty following femoral neck fracture were recruited into this study. A fixed volume (40 mL) of 0.25% levobupivacaine was injected before the induction of anesthesia using ultrasound guidance. Venous blood samples were obtained at 0, 10, 20, 30, 45, 60, 75, 90, and 120 min time points and analyzed using mass spectrometry.Results: The median (interquartile range) maximum observed plasma concentration (Cmax) of levobupivacaine was 0.48 (0.45-0.61) µg/mL, with the time to reach Cmax (tmax) of 38 minutes (30–105) after administration, a half-life of 2.8 h (1.65–5.8), and clearance rate of 0.72 L/min (0.36–1.26). The fixed volume (40 mL) of 0.25% levobupivacaine FICB did not exceed the recognized toxic threshold in adults (2.6 µg/mL). Conclusion: The data described here indicate a similar levobupivacaine PK profile for older patients undergoing FICB for hip arthroplasty compared with the levobupivacaine PK profile for the general population. ",

keywords = "Pharmacokinetics, Levobupivacaine, Local anesthetic systemic toxicity (LAST), Liquid chromatography with tandem mass spectrometry (LC-MS/MS)",

author = "Rebecca Parr and Hal Robinson and Gary Cameron and Gillian Broadbent and Heather Wallace and Thomas Engelhardt",

note = "This article was extracted from the PhD. thesis of Rebecca Parr in Scotia Biologics Ltd. LC-MS/MS. ",

year = "2020",

month = jun,

language = "English",

volume = "6",

pages = "151--156",

journal = "Pharmaceutical and Biomedical Research",

issn = "2423-4486",

number = "2",

}

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T1 - Pharmacokinetic Profile of Plasma Levobupivacaine Following Fascia Iliaca Compartment Block for Proximal Femoral Fracture in Older Patients

AU - Parr, Rebecca

AU - Robinson, Hal

AU - Cameron, Gary

AU - Broadbent, Gillian

AU - Wallace, Heather

AU - Engelhardt, Thomas

N1 - This article was extracted from the PhD. thesis of Rebecca Parr in Scotia Biologics Ltd. LC-MS/MS.

PY - 2020/6

Y1 - 2020/6

N2 - Introduction: Fascia iliaca compartment block (FICB) is commonly used in older patients to provide effective analgesia following hip fracture. However, only limited pharmacokinetic (PK) data about levobupivacaine are available to help clinical practice and establish safe volumes and amounts of local anesthetics.Methods: Ten patients aged between 53 and 87 years, who underwent hemiarthroplasty following femoral neck fracture were recruited into this study. A fixed volume (40 mL) of 0.25% levobupivacaine was injected before the induction of anesthesia using ultrasound guidance. Venous blood samples were obtained at 0, 10, 20, 30, 45, 60, 75, 90, and 120 min time points and analyzed using mass spectrometry.Results: The median (interquartile range) maximum observed plasma concentration (Cmax) of levobupivacaine was 0.48 (0.45-0.61) µg/mL, with the time to reach Cmax (tmax) of 38 minutes (30–105) after administration, a half-life of 2.8 h (1.65–5.8), and clearance rate of 0.72 L/min (0.36–1.26). The fixed volume (40 mL) of 0.25% levobupivacaine FICB did not exceed the recognized toxic threshold in adults (2.6 µg/mL). Conclusion: The data described here indicate a similar levobupivacaine PK profile for older patients undergoing FICB for hip arthroplasty compared with the levobupivacaine PK profile for the general population.

AB - Introduction: Fascia iliaca compartment block (FICB) is commonly used in older patients to provide effective analgesia following hip fracture. However, only limited pharmacokinetic (PK) data about levobupivacaine are available to help clinical practice and establish safe volumes and amounts of local anesthetics.Methods: Ten patients aged between 53 and 87 years, who underwent hemiarthroplasty following femoral neck fracture were recruited into this study. A fixed volume (40 mL) of 0.25% levobupivacaine was injected before the induction of anesthesia using ultrasound guidance. Venous blood samples were obtained at 0, 10, 20, 30, 45, 60, 75, 90, and 120 min time points and analyzed using mass spectrometry.Results: The median (interquartile range) maximum observed plasma concentration (Cmax) of levobupivacaine was 0.48 (0.45-0.61) µg/mL, with the time to reach Cmax (tmax) of 38 minutes (30–105) after administration, a half-life of 2.8 h (1.65–5.8), and clearance rate of 0.72 L/min (0.36–1.26). The fixed volume (40 mL) of 0.25% levobupivacaine FICB did not exceed the recognized toxic threshold in adults (2.6 µg/mL). Conclusion: The data described here indicate a similar levobupivacaine PK profile for older patients undergoing FICB for hip arthroplasty compared with the levobupivacaine PK profile for the general population.

KW - Pharmacokinetics

KW - Levobupivacaine

KW - Local anesthetic systemic toxicity (LAST)

KW - Liquid chromatography with tandem mass spectrometry (LC-MS/MS)

M3 - Article

SN - 2423-4486

VL - 6

SP - 151

EP - 156

JO - Pharmaceutical and Biomedical Research

JF - Pharmaceutical and Biomedical Research

IS - 2

ER -

Pharmacokinetic Profile of Plasma Levobupivacaine Following Fascia Iliaca Compartment Block for Proximal Femoral Fracture in Older Patients

Abstract

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