Cholestasis as a side effect of bupivacaine?

Abstract:

BACKGROUND AND OBJECTIVES:Cholestasis has been proposed as a side effect of interpleural bupivacaine. Therefore, the effects of various application techniques on liver enzymes were studied following ethics committee approval and informed patient consent. METHODS:Patients following scheduled thoracotomy and laparoscopic cholecystectomy were prospectively studied and randomized to the following application techniques of bupivacaine: Thoracic surgery. T0: Control (systemic analgesia only: patient-controlled analgesia with opioids; n = 26); T1: Repetitive intercostal blocks (10-20 mL 0.5% bupivacaine, 2-4 times per day for 3-6 days; n = 17); T2: Interpleural injections via a catheter placed intraoperatively (20 mL 0.25%, 4-6 times per day for 3-6 days, right: n = 25 or left: n = 12). Laparoscopic cholecystectomy. Intraperitoneal application (single injection). L0: 50 mL saline (Control) (n = 21). L1: 50 mL 0.125% bupivacaine (n = 18); L2: 50 mL 0.25% (n = 20). The serum concentrations of bilirubin, gamma-GT, alkaline phosphatase, leucine amino peptidase, glutamate oxalacetate transaminase, and glutamate pyruvate transaminase were measured preoperatively and on day 1, 3, and 7 postoperatively. RESULTS:Neither application of plain bupivacaine was associated with significant changes in the postoperative concentration of hepatic enzymes. In particular, there was no difference between left- and right-sided interpleural application. Although increases in hepatic enzyme concentrations were observed in some patients postoperatively, this was similar in the bupivacaine and control groups. CONCLUSION:Perioperative interpleural, intercostal, and intraperitoneal administration of bupivacaine was not associated with findings indicative of cholestasis in the early postoperative course.

journal_name

Reg Anesth Pain Med

authors

Wulf H,Leger R,Raetzell M,Olmer A,Scheiderer U

doi

10.1016/s1098-7339(98)90055-4

subject

Has Abstract

pub_date

1998-05-01 00:00:00

pages

278-82

issue

3

eissn

1098-7339

issn

1532-8651

pii

S1098-7339(98)90055-4

journal_volume

23

pub_type

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