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Peer-reviewedCC BYTurkish journal of anaesthesiology and reanimation

Pharmacokinetics of Local Anesthetics in Fascial Plane Blocks: Clinical Implications and Safety Considerations-A Narrative Review.

  • Musa Zengin1
  • Hadi Ufuk Yörükoğlu2
  • Oğuz Gündoğdu3
  • Aslıhan Aykut4
  • Emine Nilgün Zengin4
  • Cemre Tokuş5
  • Elif Şule Özdemir Sezgi1
  • Onur Küçük6
6 affiliations
  1. 1University of Health Sciences Türkiye, Ankara Etlik City Hospital, Clinic of Anaesthesiology and Reanimation, Ankara, Türkiye.
  2. 2Kocaeli University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Kocaeli, Türkiye.
  3. 3Sivas Cumhuriyet University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Sivas, Türkiye.
  4. 4Ankara Bilkent City Hospital, Clinic of Anaesthesiology and Reanimation, Ankara, Türkiye.
  5. 5Dokuz Eylül University Faculty of Medicine, Department of Pharmacology, İzmir, Türkiye.
  6. 6Dokuz Eylül University Faculty of Medicine, Department of Anaesthesiology and Reanimation, İzmir, Türkiye.
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Abstract

Fascial plane blocks (FPBs) are increasingly used in modern regional anaesthesia and differ from conventional nerve blocks by delivering local anesthetic (LA) into interfascial compartments. This approach results in distinct pharmacokinetics with clinically relevant systemic absorption. Pharmacokinetic behavior in FPBs is determined by interactions among patient-related factors, drug properties, adjuvant use, and fascial plane characteristics. High-volume injections, tissue vascularity, and injection technique influence peak plasma concentration and time to peak concentration. Patient variables, such as advanced age, pregnancy, obesity, malnutrition, and organ dysfunction, further increase variability and the risk of toxicity. Epinephrine may reduce the absorption rate and improve safety, whereas dexamethasone and dexmedetomidine mainly prolong analgesia through pharmacodynamic effects. Because systemic absorption is inherent to FPBs, LA systemic toxicity remains a key concern. Individualized dosing, appropriate drug selection, and close monitoring are essential for safe and effective clinical practice.

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Cite

BibTeXRIS
BibTeX
@article{zengin2026pharmacokinetics,
  title = {{Pharmacokinetics of Local Anesthetics in Fascial Plane Blocks: Clinical Implications and Safety Considerations-A Narrative Review.}},
  author = {Musa Zengin and Hadi Ufuk Yörükoğlu and Oğuz Gündoğdu and Aslıhan Aykut and Emine Nilgün Zengin and Cemre Tokuş and Elif Şule Özdemir Sezgi and Onur Küçük},
  journal = {Turkish journal of anaesthesiology and reanimation},
  year = {2026},
  month = oct,
  doi = {10.4274/tjar.2026.262464},
  url = {https://europepmc.org/article/MED/42968697},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Pharmacokinetics of Local Anesthetics in Fascial Plane Blocks: Clinical Implications and Safety Considerations-A Narrative Review.
AU  - Musa Zengin
AU  - Hadi Ufuk Yörükoğlu
AU  - Oğuz Gündoğdu
AU  - Aslıhan Aykut
AU  - Emine Nilgün Zengin
AU  - Cemre Tokuş
AU  - Elif Şule Özdemir Sezgi
AU  - Onur Küçük
PY  - 2026
DA  - 2026/10/01
JO  - Turkish journal of anaesthesiology and reanimation
DO  - 10.4274/tjar.2026.262464
UR  - https://europepmc.org/article/MED/42968697
AB  - Fascial plane blocks (FPBs) are increasingly used in modern regional anaesthesia and differ from conventional nerve blocks by delivering local anesthetic (LA) into interfascial compartments. This approach results in distinct pharmacokinetics with clinically relevant systemic absorption. Pharmacokinetic behavior in FPBs is determined by interactions among patient-related factors, drug properties, adjuvant use, and fascial plane characteristics. High-volume injections, tissue vascularity, and injection technique influence peak plasma concentration and time to peak concentration. Patient variables, such as advanced age, pregnancy, obesity, malnutrition, and organ dysfunction, further increase variability and the risk of toxicity. Epinephrine may reduce the absorption rate and improve safety, whereas dexamethasone and dexmedetomidine mainly prolong analgesia through pharmacodynamic effects. Because systemic absorption is inherent to FPBs, LA systemic toxicity remains a key concern. Individualized dosing, appropriate drug selection, and close monitoring are essential for safe and effective clinical practice.
SN  - 2667-677X
SN  - 2667-6370
ER  -