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Ropivacaine pharmacokinetics after local infiltration analgesia in hip arthroplasty
Fatin Affas1, Staffan Eksborg, Per Wretenberg
1From the Department of Physiology and Pharmacology, Section of Anesthesia and Intensive Care, Department of Women's and Children's Health, Childhood Cancer Research Unit, Section of Orthopaedics, and Department of Medicine, Clinical Pharmacology Unit, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden.
Abstract:
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.
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