Population pharmacokinetic model for tumescent lidocaine in women undergoing breast cancer surgery
| Autor: | Amélie Marsot, Marc Leone, Romain Guilhaumou, Aurélie Bourgoin, Olivier Blin, Laurent Allanioux, C Riff |
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| Přispěvatelé: | Service de Pharmacologie Clinique [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Clinical Investigation Centre (CIC-UPCET) and Department of Clinical Pharmacology, Centre investigation clinique - Unité de pharmacologie clinique et d'évaluations thérapeutiques (CIC-UPCET), Assistance Publique - Hôpitaux de Marseille (APHM)-Assistance Publique - Hôpitaux de Marseille (APHM), CHU Marseille, Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Lidocaine Epinephrine medicine.medical_treatment Population Breast Neoplasms 030226 pharmacology & pharmacy Models Biological 03 medical and health sciences 0302 clinical medicine Breast cancer Pharmacokinetics 030202 anesthesiology [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases medicine Infusion pump Humans Pharmacology (medical) Prospective Studies Anesthetics Local Prospective cohort study education Infusion Pumps Mastectomy Aged Pharmacology Aged 80 and over education.field_of_study business.industry General Medicine Middle Aged medicine.disease 3. Good health NONMEM Surgery Nonlinear Dynamics Female business medicine.drug |
| Zdroj: | European Journal of Clinical Pharmacology European Journal of Clinical Pharmacology, Springer Verlag, 2018, 74 (10), pp.1309-1315. ⟨10.1007/s00228-018-2503-8⟩ European Journal of Clinical Pharmacology, 2018, 74 (10), pp.1309-1315. ⟨10.1007/s00228-018-2503-8⟩ |
| ISSN: | 0031-6970 1432-1041 |
| DOI: | 10.1007/s00228-018-2503-8⟩ |
| Popis: | International audience; PurposeTumescent lidocaine anesthesia (TLA) is an opportunity to perform mastectomy for breast cancer without general anesthesia in elderly women. Few reports are available on the pharmacokinetics of lidocaine in a context of TLA during a unilateral mastectomy. The aim of this study was to describe lidocaine pharmacokinetics in elderly women undergoing breast cancer surgery after TLA and to explore the risk of the toxicity of this technique.MethodsA prospective study was conducted to examine the pharmacokinetics of lidocaine in women undergoing TLA. TLA consists of an intradermal lidocaine instillation (20mL, 1% [200mg]) followed by a tumescent lidocaine infiltration (100mL of 1% lidocaine [1000mg] and 0.5mg epinephrine to 1L Ringer's lactate) via an infusion pump. A population pharmacokinetic (popPK) analysis was performed using the nonlinear mixed effects model (NONMEM).ResultsThe analysis included 116 observations from 17 women with a median (range) age of 83.4 (60.5-90.0). The median tumescent lidocaine dose was 800mg (range 375-1000mg) infused over 48.011.0min. A one-compartment disposition model with first order absorption, two input compartments, and a central elimination best described the pharmacokinetics of lidocaine. The estimates (between subject variability; relative standard error, %) of apparent volume, apparent clearance, tumescent absorption rate, and instillation absorption rate were 195.0 (46.3; 14.5%) L, 24.7 (48.9; 13.3%) Lh(-1), 0.28 (39.6; 13.8%) h(-1), and 2.56 (135.3; 44.9%) h(-1), respectively.Conclusions p id=''Par4 This is the first popPK model developed to describe kinetic profiles of TLA. These findings confirm the slow diffusion of lidocaine from the tumescent deposit. |
| Databáze: | OpenAIRE |
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