THE PHARMACOKINETIC PROFILE OF BUPIVACAINE IN NORMOTENSIVE PREGNANT PATIENT DURING CAESAREAN SECTION

https://doi.org/10.22146/jmpf.105

Dita Ayulia Dwi Sandi(1*), Djoko Wahyono(2), Farida Hayati(3), Yusmein Uyun(4)

(1) Akademi Farmasi ISFI Banjarmasin Kalimantan Selatan
(2) Pascasarjana Fakultas Farmasi, Universitas Gadjah Mada Yogyakarta
(3) Fakultas Matematika dan Ilmu Pengetahuan Alam, Universitas Islam Indonesia Yogyakarta
(4) Bagian Anastesiologi, RSUP Dr. Sardjito Yogyakarta
(*) Corresponding Author

Abstract


Bupivacaine is used as a local anesthetic with Epidural Lumbal Anasthesia (ELA) for Caesarean Section (CS) in Indonesia. During pregnancy, there are changes in pharmacokinetic parameter values, as a result of changes in the physiology of the body. This study was designed to determine the pharmacokinetic parameters of isobaric bupivacaine 0.5% with non-compartment model and to monitor its effectiveness. The study was conducted on 7 normotensive pregnant patients who treated with 0.5% bupivacaine doses 75 mg at Integrated Central Surgery Building in Dr. Sardjito Hospital. Blood samples (3 mL) from each patients were drawn at the following intervals: 0, 15, 20, 25, 30, 45, 60, 75 and 90 minutes, then the plasma bupivacaine consentration were measured using HPLC and pharmacokinetic parameters were calculated with non-compartment models, i.e. AUC(0-~), AUMC(0-~) and the MRT. Monitoring the effectiveness was conducted by Pinprick test. Relationship of AUC(0-~) with maximum sensory block was analyzed by Pearson correlation. The results of pharmacokinetic parameters of isobaric bupivacaine 0.5% for 7 normotensive pregnant patients with non-compartment model were AUC(0-~) 101,25 ± 15,07 μg.mL-1.min; AUMC(0-~) 6.431,92 ± 2.212,96 μg.mL-1.min2 and MRT 63,74 ± 20,52 minutes. Bupivacaine 0,5% doses 75 mg as an anesthetic for CS with ELA in 7 normotensive pregnant patients was effective for pain blockade, with maximum sensory block was T6. There was no correlation between AUC(0-~) and sensory block (p>0,05).

Keywords: Bupivacaine 0.5%, Sectio Caesarea, Pharmacokinetics, Sensory bloc


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DOI: https://doi.org/10.22146/jmpf.105

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