Ropivacaine plasma levels following high-dose local infiltration analgesia for total knee arthroplasty.

Abstract:

:We measured total and free plasma concentrations of ropivacaine following high-volume, high-dose local infiltration analgesia in 28 patients aged 65 years or over undergoing unilateral total knee arthroplasty. Patients received infiltration of ropivacaine 400 mg followed by infusion at 20 mg.h(-1) through an intra-articular catheter. Total and free plasma levels of ropivacaine were measured at specified time intervals during a 24-h period after tourniquet release. Patients were monitored for symptoms and signs of local anaesthetic toxicity. Total levels of plasma ropivacaine varied from 0.147 to 3.093 μg.ml(-1) (mean (SD) 1.105 (0.518) μg.ml(-1) ). Free levels of plasma ropivaca-ine varied from 0.001 to 0.104 μg.ml(-1) (mean (SD) 0.037 (0.020) μg.ml(-1) ). Six samples had total plasma ropivacaine levels greater the toxic threshold of 2.2 μg.ml(-1) . No samples reached the toxic threshold for free venous ropivacaine concentration. We conclude that the use of high-dose ropivacaine infiltration and catheter infusion for total knee arthroplasty in an elderly population does not result in free plasma ropivacaine levels previously associated with toxicity but that raised total plasma levels may be observed.

journal_name

Anaesthesia

journal_title

Anaesthesia

authors

Brydone AS,Souvatzoglou R,Abbas M,Watson DG,McDonald DA,Gill AM

doi

10.1111/anae.13017

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

784-90

issue

7

eissn

0003-2409

issn

1365-2044

journal_volume

70

pub_type

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