Systemic Absorption of Lidocaine from Continuous Erector Spinae Plane Catheters After Congenital Cardiac Surgery: A Retrospective Study

被引：13

作者：

Caruso, Thomas J. ^{[1
]}

Lin, Carole ^{[1
]}

O'Connell, Chloe ^{[1
]}

Weiss, David ^{[1
]}

Boltz, Gail ^{[1
]}

Wu, May ^{[2
]}

Kwiatkowski, David ^{[3
]}

Maeda, Katsuhide ^{[4
]}

Tsui, Ban C. H. ^{[1
]}

机构：

[1] Stanford Univ, Sch Med, Div Pediat Anesthesia, Dept Anesthesiol Perioperat & Pain Med, 300 Pasteur Dr,H3580, Stanford, CA 94305 USA

[2] Lucile Salter Packard Childrens Hosp Stanford, Dept Pharm, Stanford, CA USA

[3] Lucile Salter Packard Childrens Hosp Stanford, Cardiovasc Intens Care Unit, Stanford, CA USA

[4] Lucile Salter Packard Childrens Hosp Stanford, Dept Cardiothorac Surg, Stanford, CA USA

来源：

JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA | 2020年 / 34卷 / 11期

关键词：

Erector spinae plane block (ESPB) catheters; Serum lidocaine; Cardiopulmonary bypass (CPB); CARDIOPULMONARY BYPASS; INTRAVENOUS LIDOCAINE; TOXICITY; BLOCKS; HEART; STERNOTOMY; ANALGESIA; RECOVERY; EFFICACY;

D O I：

10.1053/j.jvca.2020.05.040

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Objectives: To examine postoperative serum lidocaine levels in patients with intermittent lidocaine bolus erector spinae plane block (ESPB) catheters after cardiac surgery with or without cardiopulmonary bypass (CPB). Design: A retrospective study. Setting: Single-center pediatric quaternary teaching hospital. Participants: Patients who received ESPB catheters after congenital cardiac surgery from April 2018 to March 2019. Interventions: Postoperative serum lidocaine levels were extracted from the record. Measurements and Main Results: Twenty-seven of 40 patients were included in the final analyses (19 with CPB and 8 with no CPB, age 147 years, undergoing congenital heart repair). Patients who received ropivacaine or were missing data were excluded. The initial intraoperative bolus of lidocaine ranged from 0- to- 3.72 mg/kg, and the range of postoperative intermittent lidocaine boluses ranged from 0.35- to- 0.83 mg/kg, which were administered every hour. Serum lidocaine levels were measured by the hospital laboratory and ranged from <0.05to 3.0 mu g/mL in the CPB group and from <0.05 to3.2 mu g/mL in the noCPB group. CPB was not associated with differences in lidocaine levels when controlling for time (P = 0.529). Lidocaine concentrations ranged from 0.50 to1.68 mu g/mL in the CPB group and 0.86 to2.07 mu g/mL in the noCPB group. There was a normally distributed overall mean peak level of 1.818 standard deviation of 0.624 mu g/mL, with 95% confidence interval of 0.57 to3.06 mu g/mL. No patients had clinical signs of toxicity. Conclusion: Postoperative serum lidocaine concentrations did not appreciably differ due to CPB. Serum lidocaine concentrations did not reach neartoxic doses despite the presence of additional lidocaine in the cardioplegia. The results suggested that lidocaine for ESPBs after cardiac surgery is below systemic toxic range at the doses described. (c) 2020 Elsevier Inc. All rights reserved.

引用

页码：2986 / 2993

页数：8

共 26 条

[1] Local Anesthetic Systemic Toxicity Induced Cardiac Arrest After Topicalization for Transesophageal Echocardiography and Subsequent Treatment With Extracorporeal Cardiopulmonary Resuscitation [J].