Epinephrine, absorption, and local anaesthetic systemic toxicity: insights from continuous fascial block pharmacokinetic models

De Cassai A., Dost B., Mormando G., Stecco C.

British Journal of Anaesthesia, cilt.135, sa.4, ss.857-860, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Editöre Mektup
  • Cilt numarası: 135 Sayı: 4
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1016/j.bja.2025.06.033
  • Dergi Adı: British Journal of Anaesthesia
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, EMBASE
  • Sayfa Sayıları: ss.857-860
  • Anahtar Kelimeler: erector spinae plane block, fascia, local anaesthetic, pharmacokinetics, safety, toxicity, transversus abdominus plane block
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

Fascial plane blocks have become increasingly popular owing to their technical ease and inclusion in postoperative analgesia guidelines, although uncertainties about their mechanisms and safety remain. A recent study of the impact of epinephrine on levobupivacaine pharmacokinetics in continuous fascial plane blocks proposes a potential safe dosing threshold and highlights the role of epinephrine in reducing systemic absorption. The study presents promising findings that advance our understanding of local anaesthetic pharmacokinetics in fascial blocks while raising important questions about drug absorption, patient-specific risk factors for local anaesthetic systemic toxicity, and the incompletely understood microanatomy of fascial tissues.