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High plasma ropivacaine concentrations after fascia iliaca compartment block in children

O Paut1, E Schreiber, F Lacroix

  • 1Department of Paediatric Anaesthesia, Children CHU Timone Hospital, 13385 Marseille Cedex 5, France. olivier.paut@mail.ap-hm.fr

British Journal of Anaesthesia
|January 27, 2004
PubMed

Insights

High doses of ropivacaine in pediatric fascia iliaca compartment (FIC) blocks may lead to concerning plasma concentrations. Lower ropivacaine dosages are recommended for pediatric FIC blocks to ensure patient safety.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Local anesthetic pharmacokinetics vary with administration method.
  • Fascia iliaca compartment (FIC) blocks are used for pediatric pain management.
  • Ropivacaine is a common local anesthetic for regional blocks.

Purpose of the Study:

  • To compare the pharmacokinetics of two ropivacaine doses after FIC block in children.
  • To evaluate the safety and efficacy of different ropivacaine concentrations for pediatric FIC blocks.

Main Methods:

  • Prospective, double-blind study design.
  • Children received FIC block with either 0.375% or 0.5% ropivacaine (0.7 ml/kg).
  • Plasma ropivacaine concentrations measured via gas-liquid chromatography up to 6 hours post-injection.

Main Results:

  • FIC block provided effective perioperative pain relief.
  • High plasma ropivacaine concentrations (Cmax 4.33-5.6 µg/mL) observed in 3/4 patients receiving 0.5% solution.
  • Plasma concentrations in the 0.375% group were within the safe range (Cmax 0.66-0.98 µg/mL).
  • No observed signs of toxicity despite high concentrations.

Conclusions:

  • Ropivacaine administration at 3.5 mg/kg via FIC block can result in sustained, high plasma concentrations.
  • Lower ropivacaine dosages are recommended for FIC blocks in pediatric patients.
  • The study was discontinued due to observed high plasma concentrations.
Abstract

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