Continuous fascia iliaca compartment block in children: A prospective evaluation of plasma bupivacaine concentrations, pain scores, and side effects

We sought to determine the plasma concentrations of bupivacaine and its mai n metabolite after continuous fascia iliaca compartment (FIC) block in chil dren. Twenty children (9.9 +/- 4 yr, 38 +/- 19 kg) received a continuous FT C block for either postoperative analgesia (n = 16) or femoral shaft fractu re (n = 4). A bolus dose of 0.25% bupivacaine (1.56 +/- 0.3 mg/kg) with epi nephrine was followed by a continuous administration of 0.1% bupivacaine (0 .135 +/- 0.03 mg.kg(-1).h(-1)) for 48 h. Plasma bupivacaine levels were det ermined at 24 h and 48 h by using gas liquid chromatography. Heart rate, ar terial blood pressure, respiratory rate, side effects, and pain scores were recorded at 4-h intervals during 48 h. No significant differences were fou nd between mean plasma bupivacaine levels at 24 h (0.71 +/- 0.4 mug/mL) and at 48 h (0.84 +/- 0.4 mug/mL) (P = 0.33). FTC block provided adequate anal gesia in most cases. No severe adverse effects were noted. We conclude that the bupivacaine plasma concentrations during continuous FIC block in child ren are within the safety margins. FIC block is well tolerated, and provide s satisfactory pain relief in most cases.