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British Journal of Anaesthesia, 1991, Vol. 66, No. 3 310-313
© 1991 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

PLASMA CONCENTRATIONS OF BUPIVACAINE FOLLOWING COMBINED SCIATIC AND FEMORAL 3 IN 1 NERVE BLOCKS IN OPEN KNEE SURGERY

U. MISRA, F.F.A.R.C.S.I., A. K. PRIDIE, F.C.ANAES., C. MCCLYMONT, F.C.ANAES. and S. BOWER

Freeman Hospital Newcastle Upon Tyne
University Department of Anaesthetics, Royal Victoria Infirmary Newcastle Upon Tyne NE1 4LP

We administered combined femoral 3 in 1 and sciatic nerve blocks to provide postoperative pain relief in 22 consecutive patients undergoing elective knee replacement surgery under spinal anaesthesia. The patients were allocated randomly to two groups. In group A (n=11) the blocks were performed with 0.5% bupivacaine (with adrenaline) 3 mg/kg body weight and in group B (n=11) 0.5% plain bupivacaine in the same dose was used. Serial plasma concentrations of bupivacaine were measured for up to 2 h and the duration of postoperative analgesia was measured in both groups. No significant differences were found between the two groups. There were no clinical signs or symptoms of bupivacaine toxicity in each group. This study demonstrated that, after combined sciatic and 3 in 1 femoral block, concentrations of bupivacaine associated with toxicity were not reached, even though the dose of bupivacaine administered exceeded the manufacturer's recommended dose by 50%.


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