Cerebrospinal Fluid Bioavailability and Pharmacokinetics of Bupivacaine and Lidocaine after Intrathecal and Epidural Administrations in Rabbits Using Microdialysis

  1. Rozenn Clement,
  2. Jean-Marc Malinovsky,
  3. Pascal Le Corre,
  4. Gilles Dollo,
  5. Francois Chevanne and
  6. Roger Le Verge
  1. Laboratoire de Pharmacie Galénique et Biopharmacie, Faculté des Sciences Pharmaceutiques et Biologiques, Université de Rennes, Rennes Cedex, France

    Abstract

    The aim of this work was to study the cerebrospinal fluid (CSF) bioavailability and pharmacokinetics of bupivacaine (BUP) and lidocaine (LID) administered separately in rabbits using microdialysis with retrodialysis calibration. Microdialysis probe and catheters were inserted under control of the view in the intrathecal or epidural spaces. The epidural disposition of BUP and LID after epidural administration of low (0.69 μM) and high (6.9 μM) doses was studied. Then, the intrathecal and plasma dispositions after separate intrathecal (0.2 μM) and epidural administration (6.9 μM) were investigated. The CSF binding of BUP and LID was linear in a range from 50 to 500 μg/ml, and the mean unbound CSF fraction at a concentration of 100 μg/ml was 39.3 ± 2.3% for BUP and 75.8 ± 7.7% for LID. Epidural and intrathecal disposition of BUP and LID showed a biexponential decline. After epidural administration, the CSF concentrations of BUP and LID were much higher than those in plasma. After intrathecal administration, the plasma concentrations were below the limit of quantitation. Although the absorption rate of BUP appeared higher than that of LID, the mean CSF bioavailability of epidural BUP and LID was 5.5 and 17.7%, respectively. The unexpectedly higher CSF bioavailability of LID, the less lipophilic drug, may result from the difference in the processes competing for drug epidural removal.

    Footnotes

    • Send reprint requests to: Dr. Pascal Le Corre, Laboratoire de Pharmacie Galénique et Biopharmacie, Faculté des Sciences Pharmaceutiques et Biologiques, Université de Rennes 1, 35043 Rennes Cedex, France. E-mail:Pascal.le-corre{at}univ-rennes1.fr

    • Abbreviations:
      CSF
      cerebrospinal fluid
      BUP
      bupivacaine
      LID
      lidocaine
      RL
      relative loss
      RR
      relative recovery
      Cmax
      maximum total plasma concentration
      Cmax-epi
      maximum unbound epidural concentration
      Tmax
      peak plasma concentration time
      Tmax-csf
      peak CSF concentration time
      AUClast
      area under CSF concentration-time curves from the time of drug administration up to the last sampling point
      AUCcsf-it
      area under the unbound CSF concentration-time curve up to the last sampling point after intrathecal administration
      AUCcsf-epi
      area under the unbound CSF concentration-time curve up to the last sampling point after epidural administration
      AUCinf
      area under CSF concentration-time curves from the time of drug administration to infinity
      K10
      elimination rate constant
      K12 and K21
      distribution rate constants
      Ka
      absorption rate constant
      V1
      initial volume of distribution
      Vss
      steady-state volume of distribution
      Fcsf
      CSF bioavailability
      Cinj
      drug concentration of the solution injected
      CLE
      elimination clearance
      CLI
      intercompartmental clearance
      • Received July 10, 1998.
      • Accepted January 7, 1999.
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