Bupivacaine and Other Amide Local Anesthetics Inhibit the Hydrolysis of Chloroprocaine by Human Serum.

: The rate of hydrolysis of chloroprocaine by human serum was studied in the presence and absence of a number of amide local anesthetics and their metabolites. Bupivacaine (2.4 [mu]g/ml) and etidocaine (2.3 [mu]g/ml) caused 38% and 21% inhibition respectively of the rate of chloroprocaine hydrolysis. Circulating concentrations of these drugs have been reported in this range by several investigators following epidural doses of 150 to 400 mg of either drug. Mepivacaine, lidocaine, and two lidocaine metabolites (glycine xylidide and monoethylglycine xylidide) were only inhibitory at levels much greater than those seen in blood following the usual local anesthetic doses of the parent compounds. Since serum is an important site of chloroprocaine metabolism in man, the probability of chloroprocaine intoxication may be increased when it is administered with local anesthetics such as bupivacaine and etidocaine. (C) 1978 International Anesthesia Research Society