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Blood Bupivacaine Concentrations After a Combined Single-Shot Sciatic Block and a Continuous Femoral Nerve Block in Pediatric Patients: A Prospective Observational Study.

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Anesthesia & Analgesia: August 31, 2016

AUTHORS: Suresh, Santhanam MD et al

BACKGROUND: We evaluated blood bupivacaine concentrations in children having a single-shot sciatic and continuous femoral blocks after anterior cruciate ligament repair.

METHODS: Dried blood spot samples were analyzed for bupivacaine levels at 0, 5, 15, 30, 60, and 120 minutes and 4, 24, and 48 hours.

RESULTS: The highest 99% upper confidence interval limit was 135 ng/mL at the 4-hour evaluation point. The 99% upper confidence interval was below potentially toxic levels (1500 ng/mL) across all sampling times.

CONCLUSIONS: The risk of local anesthetic toxicity in pediatric patients receiving single-shot sciatic and continuous femoral nerve blocks is very low.

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