Plasma bupivacaine concentrations during combined regional and general anaesthesia for resection and reconstruction of head and neck carcinomata.

Venous plasma bupivacaine concentrations were measured in patients undergoing resection and reconstruction surgery for intra-oral malignancy. Vth cranial nerve and cervical plexus blocks were performed using 0.5% bupivacaine. Total dosage was higher than recommended by U.K. manufacturers. Mean peak venous plasma concentrations were higher than previously recorded. A significant different was found in the peak concentrations when adrenaline was included. The significance of these results in relation to systemic toxicity and recommended dosage is discussed.