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

Gill, A. M. and Scott, N. B. and Abbas, M. and Watson, D. G. and Place, K. and McDonald, David (2015) Ropivacaine plasma levels following high-dose local infiltration analgesia for total knee arthroplasty. Anaesthesia, 70 (7). pp. 784-790. ISSN 0003-2409 (https://doi.org/10.1111/anae.13017)

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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<sup>-1</sup> 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<sup>-1</sup> (mean (SD) 1.105 (0.518) μg.ml<sup>-1</sup>). Free levels of plasma ropivaca-ine varied from 0.001 to 0.104 μg.ml<sup>-1</sup> (mean (SD) 0.037 (0.020) μg.ml<sup>-1</sup>). Six samples had total plasma ropivacaine levels greater the toxic threshold of 2.2 μg.ml<sup>-1</sup>. 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.

ORCID iDs

Gill, A. M., Scott, N. B., Abbas, M., Watson, D. G. ORCID logoORCID: https://orcid.org/0000-0003-1094-7604, Place, K. and McDonald, David;
  • Item type:Article
    ID code:54800
    Dates:
    Date
    Event
    1 July 2015
    Published
    22 February 2015
    Published Online
    30 December 2014
    Accepted
    Notes:This is the peer reviewed version of the following article: Gill, A. M., Scott, N. B., Abbas, M., Watson, D. G., Place, K., & McDonald, D. A. (2015). Ropivacaine plasma levels following high-dose local infiltration analgesia for total knee arthroplasty. Anaesthesia, 70(7), 784-790., which has been published in final form at http://dx.doi.org/10.1111/anae.13017. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
    Subjects:Medicine > Pharmacy and materia medica
    Medicine > Surgery
    Department:Faculty of Science > Strathclyde Institute of Pharmacy and Biomedical Sciences
    Depositing user: Pure Administrator
    Date deposited:11 Dec 2015 01:38
    Last modified:18 Nov 2024 01:08
    Related URLs:
    URI:https://strathprints.strath.ac.uk/id/eprint/54800
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