Document Detail

Pharmacokinetics of 450 mg ropivacaine with and without epinephrine for combined femoral and sciatic nerve block in lower extremity surgery. A pilot study.
MedLine Citation:
PMID:  23013208     Owner:  NLM     Status:  MEDLINE    
AIMS: No pharmacokinetic data exist on doses of ropivacaine larger than 300 mg for peripheral nerve block in man, although in clinical practice higher doses are frequently used. The purpose of the present study was to describe the pharmacokinetic profile in serum of 450 mg ropivacaine with and without epinephrine in patients undergoing anterior cruciate ligament reconstruction.
METHODS: Twelve patients were randomly allocated to receive a single shot combined sciatic/femoral nerve block with 60 ml of either ropivacaine 0.75% alone (group R, n = 6) or ropivacaine 0.75% plus epinephrine 5 μg ml(-1) (group RE, n = 6). Venous blood samples for total and free ropivacaine serum concentrations were obtained during 48 h following block placement. Pharmacokinetic parameters were calculated using a non-compartmental approach.
RESULTS: Results are given as mean (SD) for group R vs. group RE (95% CI of the difference). Total Cmax was 2.81 (0.94) μg ml(-1) vs. 2.16 (0.21) μg ml(-1) (95% CI -0.23, 1.53). tmax was 1.17 (0.30) h vs. 1.67 (0.94) h (95% CI -1.40, 0.40). The highest free ropivacaine concentration per patient was 0.16 (0.08) μg ml(-1) vs. 0.12 (0.04) μg ml(-1) (95% CI -0.04, 0.12). t(1/2) was 6.82 (2.26) h vs. 5.48 (1.69) h (95% CI -1.23, 3.91). AUC was 28.35 (5.92) μg ml(-1)  h vs. 29.12 (7.34) μg ml(-1)  h (95% CI -9.35, 7.81).
CONCLUSIONS: Free serum concentrations of ropivacaine with and without epinephrine remained well below the assumed threshold of 0.56 μg ml(-1) for systemic toxicity. Changes in pharmacokinetics with epinephrine co-administration did not reach statistical significance.
Karin P W Schoenmakers; Tom B Vree; Nigel T M Jack; Bart van den Bemt; Jacques van Limbeek; Rudolf Stienstra
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of clinical pharmacology     Volume:  75     ISSN:  1365-2125     ISO Abbreviation:  Br J Clin Pharmacol     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-08     Completed Date:  2013-10-01     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  7503323     Medline TA:  Br J Clin Pharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1321-7     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.
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MeSH Terms
Amides / administration & dosage,  pharmacokinetics*
Anesthetics, Local / pharmacokinetics*
Anterior Cruciate Ligament Reconstruction*
Dose-Response Relationship, Drug
Drug Interactions
Drug Therapy, Combination
Epinephrine / administration & dosage,  pharmacokinetics*
Femoral Nerve / drug effects*
Middle Aged
Nerve Block / methods
Pilot Projects
Random Allocation
Sciatic Nerve / drug effects*
Vasoconstrictor Agents / administration & dosage,  pharmacokinetics*
Young Adult
Reg. No./Substance:
0/Amides; 0/Anesthetics, Local; 0/Vasoconstrictor Agents; 7IO5LYA57N/ropivacaine; YKH834O4BH/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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