The kinetics of bupivacaine (Carbostesin) plasma concentrations during epidural anesthesia following intraoperative bolus injection and subsequent continuous infusion.

Plasma levels of bupivacaine were measured in 25 patients undergoing major abdominal surgery. The pharmacokinetic analysis of these data shows: (1) under a short term treatment, i.e. in the initial phase where multiple injections are given, the kinetic properties are in accordance with linear kinetic theory. The data can best be fitted to a two-compartment-model. (2) under a longterm treatment, i.e. infusion for more than 50 h, a very high accumulation occurs in contradiction to this theory. Therefore, the calculation of plasma levels from initial kinetic data is not feasible.