Evaluation of the effects of levobupivacaine on clotting and fibrinolysis using thromboelastography.
Affiliation
Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, and University College Cork, Ireland.Issue Date
2012-02-03T15:12:40ZMeSH
AdultAnesthesia, Epidural
Anesthetics, Local/*pharmacology
Blood Coagulation/*drug effects
Blood Patch, Epidural
Bupivacaine/*pharmacology
Female
Fibrinolysis/*drug effects
Humans
Male
Prospective Studies
*Thrombelastography
Metadata
Show full item recordCitation
Eur J Anaesthesiol. 2000 Jun;17(6):373-8.Journal
European journal of anaesthesiologyPubMed ID
10928437Abstract
Amide local anaesthetics inhibit platelet function. We hypothesized that residual anaesthetic in the epidural space could decrease efficacy of an epidural blood patch in preventing postdural puncture headache. Levobupivacaine has recently been approved for epidural anaesthesia. Its effects on coagulation have not previously been studied. The aim of this study was to determine the effects of levobupivacaine on clotting using thromboelastography. Ten ASA Class I volunteers were studied. Venous blood samples were analysed using a Haemoscope 2000D TEG analyser. Whole blood, a 50% saline control and two levobupivacaine solutions (2.5 mg mL(-1) and 2.5 microg mL(-1) in blood) were compared. The former reproduces that produced in the epidural space by blood (20 mL for an epidural blood patch) and levobupivacaine 0.5% (20 mL). The latter approximates plasma concentrations following epidural injection of levobupivacaine 0.5% (20 mL). P < 0.05 was considered significant. Maximum amplitude (MA), a measure of clot strength, is decreased by levobupivacaine 2.5 mg mL(-1). Levobupivacaine 2.5 mg mL(-1) decreases clot strength and may reduce efficacy of a prophylactic epidural blood patch.Language
engISSN
0265-0215 (Print)0265-0215 (Linking)