Ropivacaine Pharmacokinetics After Local Infiltration Analgesia in Hip Arthroplasty

• Published in: Anesthesia and analgesia Vol. 119; no. 4; pp. 996 - 999
• Main Authors: Affas, Fatin, Eksborg, Staffan, Wretenberg, Per, Olofsson, Christina, Stiller, Carl-Olav
• Format: Journal Article
• Language: English
• Published: United States International Anesthesia Research Society 01-10-2014
• Subjects: Adult; Aged; Aged, 80 and over; Amides - administration & dosage; Amides - blood; Amides - pharmacokinetics; Anesthesia, Spinal - methods; Anesthetics, Local - administration & dosage; Anesthetics, Local - blood; Anesthetics, Local - pharmacokinetics; Arthroplasty, Replacement, Hip - adverse effects; Female; Humans; Male; Medicin och hälsovetenskap; Middle Aged; Pain, Postoperative - blood; Pain, Postoperative - prevention & control; Pilot Projects
• ISSN: 0003-2999; 1526-7598; 1526-7598
• DOI: 10.1213/ANE.0000000000000364

In this study, we determined the plasma concentration of ropivacaine by liquid chromatography-mass spectrometry for 30 hours after local infiltration analgesia in 15 patients with elective hip arthroplasty. The 95% upper prediction bound of maximal unbound plasma concentration of ropivacaine was 0.032 mg/L. Side effects sufficient to stop an IV infusion have been reported at arterial concentrations of 0.34 to 0.85 mg/L. Alpha-1-acid glycoprotein did not correlate with the fraction of unbound ropivacaine during the first 24 hours after local infiltration analgesia. No signs or symptoms of systemic local anesthetic toxicity were observed. The Clopper-Pearson 95% upper confidence limit for adverse signs was 0.218.