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The Influence of Adrenalin on the Pharmacokinetics of Interpleurally Administered Lidocaine in Patients With Pancreatic Neoplasia
Author(s) -
Calvo Begoña,
Pedraz José L.,
Gascón Alicia R.,
Hernández Rosa M.,
GarcíaOrtega E.,
Vara F.,
Muriel Clemente,
DomínguezGil Alfonso
Publication year - 1995
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1995.tb04084.x
Subject(s) - pharmacokinetics , lidocaine , medicine , pharmacology , anesthesia
The influence of adrenalin on the pharmacokinetics of lidocaine given interpleurally to 10 patients with pancreatic neoplasia was studied. Five patients received an interpleural dose of lidocaine (200 mg; control group), and 5 patients received an interpleural dose of lidocaine (200 mg) plus adrenalin (1:200,000). Plasma and cerebrospinal fluid (CSF) levels of lidocaine were measured before and at specified times (up to 8 hours) after the dose. The analytical technique was radioimmunoassay; and plasma and CSF data were assessed using noncompartmental analysis. The drug was quickly absorbed into the plasma in the control group (C max = 2.76 ± 0.10 μg/mL at 0.33 ± 0.14 hours after administration); whereas drug access to CSF was decreased and occurred slowly (C max = 0.32 ± 0.07 μg/mL at 1.66 ± 1.35 hours). The drug was eliminated more quickly from plasma than from CSF, with half‐lives of 1.71 ± 0.43 hours and 3.86 ± 1.27 hours, respectively. The simultaneous administration of adrenalin delayed absorption (t max = 0.91 ± 0.52 hours). The drug elimination half‐lives in plasma and CSF of this group increased to 3.22 ± 1.22 hours and 8.71 ± 3.28 hours, respectively. The duration of the analgesia, evaluated as the time until the patient needed another dose, increased from 8.2 ± 1.5 hours in the control group to 9.7 ± 1.3 hours in the group that received adrenalin. From these results the levels that would be reached on a multiple‐dose regimen (D = 200 mg, r = 8 hours) were predicted. In the second group, the drug accumulated in the CSF. This may lead to adverse central nervous system (CNS) side effects when adrenalin is given simultaneously with lidocaine.