Luz G, Innerhofer P, Bachmann B, Frischhut B, Menardi G, Benzer A
Department of Anesthesia, University Hospital, Innsbruck, Austria.
Anesth Analg. 1996 Feb;82(2):231-4. doi: 10.1097/00000539-199602000-00002.
Venous bupivacaine plasma concentrations were measured in six neonates and infants aged 4 days to 3.9 mo (mean, 2.1 mo) and 10 infants and children aged 9 mo to 6 yr (mean, 3.1 yr) after administration of an initial bolus of 0.5 mL/kg bupivacaine 0.25%, followed by a continuous infusion of local anesthetic (0.25 mL.kg-1.h-1) over a period of 4 h (first hour: bupivacaine 0.25%, then reduced to 0.125%). Plasma concentrations of local anesthetic measured at 180 min and 300 min after beginning of bupivacaine administration were significantly higher in younger infants when compared to older infants and children (180 min: 0.67 +/- 0.24 micrograms/mL [0.25-0.97] vs 0.27 +/- 0.11 micrograms/mL [0.19-0.55], P < 0.01; 300 min: 0.86 +/- 0.36 micrograms/mL [0.35-1.25] vs 0.34 +/- 0.12 micrograms/mL [0.18-0.57], P < 0.01). The results of our study show that despite applying the same dosage of epidural bupivacaine significantly higher plasma concentrations were seen after short periods of continuous infusion in infants up to 4 mo than in children older than 9 mo.
对6名年龄在4天至3.9个月（平均2.1个月）的新生儿和婴儿以及10名年龄在9个月至6岁（平均3.1岁）的婴儿和儿童，在给予0.5 mL/kg 0.25%布比卡因初始推注量后，持续4小时输注局部麻醉剂（0.25 mL·kg⁻¹·h⁻¹）（第一小时：布比卡因0.25%，之后降至0.125%），测量其静脉血中布比卡因的血浆浓度。与较大婴儿和儿童相比，在布比卡因给药开始后180分钟和300分钟测量的局部麻醉剂血浆浓度在较小婴儿中显著更高（180分钟：0.67±0.24微克/毫升[0.25 - 0.97] vs 0.27±0.11微克/毫升[0.19 - 0.55]，P < 0.01；300分钟：0.86±0.36微克/毫升[0.35 - 1.25] vs 0.34±0.12微克/毫升[0.18 - 0.57]，P < 0.01）。我们的研究结果表明，尽管应用相同剂量的硬膜外布比卡因，但在持续输注4个月以下婴儿短时间后，其血浆浓度比9个月以上儿童显著更高。
