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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-4570

Maurer, K; Blumenthal, S; Rentsch, K M; Schmid, E R (2008). Continuous extrapleural infusion of ropivacaine 0.2% after cardiovascular surgery via the lateral thoracotomy approach. Journal of Cardiothoracic and Vascular Anesthesia, 22(2):249-254.

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Abstract

OBJECTIVE: The pharmacokinetics of ropivacaine 0.2% were evaluated during a 48-hour continuous extrapleural infusion with 2 different infusion rates in patients undergoing cardiovascular surgery. The hypotheses that no toxic plasma concentrations of ropivacaine would be reached and that proportionality exists among plasma concentrations and dosage used were tested. DESIGN: A prospective, randomized, nonblinded study. SETTING: The investigation was performed as a single-center study in the Division of Cardiovascular Anesthesia, University Hospital of Zurich, in Switzerland. PARTICIPANTS: Seventeen consenting adults scheduled for elective cardiovascular surgery, with or without extracorporeal bypass, via the lateral thoracotomy approach were enrolled. INTERVENTIONS: For postoperative pain relief, patients were randomly assigned to receive continuous extrapleural infusion of ropivacaine 0.2% at a rate of either 6 or 9 mL/h over 48 hours. MEASUREMENTS AND MAIN RESULTS: Plasma concentrations of ropivacaine reached toxic levels (>2.2 mg/L) in 25% of cases. No proportionality of plasma concentrations of ropivacaine existed when the 2 dosing regimens were compared. CONCLUSIONS: Plasma concentrations of ropivacaine, administered at the given dose and rates during continuous extrapleural infusion, are unpredictable and may reach toxic levels in patients undergoing major cardiothoracic surgery.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Clinical Chemistry
04 Faculty of Medicine > University Hospital Zurich > Institute of Anesthesiology
DDC:610 Medicine & health
540 Chemistry
Language:English
Date:2008
Deposited On:04 Dec 2008 13:26
Last Modified:27 Nov 2013 21:19
Publisher:Elsevier
ISSN:1053-0770
Publisher DOI:10.1053/j.jvca.2007.06.005
PubMed ID:18375328

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