What is the clinical evidence from this study?

Study design: Observational. Intervention: Older age (>55 years) vs. Age 20 to 55 years. Primary outcome: Onset and upper level of analgesia, duration of anesthesia, and pharmacokinetics.

What does this research mean for the field?

In patients receiving epidural bupivacaine, older age decreases the onset time of analgesia in caudad segments, increases the upper level of analgesia, reduces total plasma clearance, and prolongs the terminal elimination half-life. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 1, 1987Anesthesia & Analgesia

Epidural Anesthesia with Bupivacaine

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Key result

Older age linked to higher epidural analgesia levels and prolonged bupivacaine half-life.

Why the study?

Effects of aging on epidural administration of 0.5% bupivacaine without epinephrine were studied to understand age-related pharmacodynamic and pharmacokinetic changes.

Does age affect the pharmacodynamics and pharmacokinetics of epidural bupivacaine?

Population

Patients aged 20-55 years and older than 55 years

Comparison

Younger group (20-55 years) vs older group (>55 years)

Design

Observational study

Authors

BVBernadette VeeringLeiden University Medical Center ABAnton G. L. BurmLeiden University JKJack W. van KleefLeiden University

Discussion

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Implication

Age increases cephalad spread and slows bupivacaine clearance after epidural; leaves open whether dose reduction improves safety in elderly patients.

Study Design

Type

Observational

Structured PICO

Does age affect the pharmacodynamics and pharmacokinetics of epidural bupivacaine?

Population

Patients aged 20 to 55 years and older than 55 years receiving epidural administration of 95 mg bupivacaine HCl.

Exposure

Epidural administration of 0.5% bupivacaine without epinephrine (95 mg bupivacaine HCl).

Comparator

Comparison between the two age groups (20-55 years vs >55 years).

Outcome

Onset of analgesia, upper level of analgesia, duration of anesthesia, and pharmacokinetic parameters (total plasma clearance, terminal half-life, peak plasma concentrations, time to peak concentrations).surrogate

Aging alters the pharmacokinetics and spread of epidural bupivacaine, with decreased clearance and increased terminal half-life in older patients.

Cite This Study

Veering et al. (1987) reported an observational. Older age (>55 years) vs. Age 20 to 55 years was evaluated on Onset and upper level of analgesia, duration of anesthesia, and pharmacokinetics. Older age (>55 years) decreased the onset of analgesia in caudad segments, increased the upper level of analgesia, decreased total plasma clearance, and increased terminal half-life.

synapsesocial.com/papers/6aae04080931602814b8baaa https://doi.org/10.1213/00000539-198707000-00001

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Implication

Age increases cephalad spread and slows bupivacaine clearance after epidural; leaves open whether dose reduction improves safety in elderly patients.

Epidural Anesthesia with Bupivacaine

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

Epidural Anesthesia with Bupivacaine

Discussion

Member takes

Implication

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider