Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Population pharmacokinetics of ropivacaine used for local infiltration anaesthesia during primary total unilateral and simultaneous bilateral knee arthroplasty

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Sphenopalatine ganglion block for the treatment of postdural puncture headache in paediatric patients

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  2. Peripheral nerve block anaesthesia and postoperative pain in acute ankle fracture surgery: the AnAnkle randomised trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. MINS and postoperative haemoglobin: statistics versus reality?

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  4. Association between cerebrospinal fluid biomarkers of neuronal injury or amyloidosis and cognitive decline after major surgery

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. No increase in postoperative contacts with the healthcare system following outpatient total hip and knee arthroplasty

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Thromboembolic and bleeding complications following primary total knee arthroplasty: a Danish nationwide cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Acute Postoperative Pain Trajectory Groups: Comment

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

Vis graf over relationer

BACKGROUND: Ropivacaine is commonly used in local infiltration anaesthesia (LIA) as pain management after total knee arthroplasty (TKA). Although considered safe, no studies evaluated the pharmacokinetics of high-dose ropivacaine infiltration in simultaneous bilateral TKA.

METHODS: We studied 13 patients undergoing unilateral and 15 undergoing bilateral TKA. Standard LIA technique was used with ropivacaine 0.2%, 200 ml (400 mg) injected peri-articularly in each knee. Free and total plasma concentrations of ropivacaine were measured within 24 h using liquid chromatography-mass spectrometry. A population pharmacokinetic model was built using non-linear mixed-effects models.

RESULTS: Peak free ropivacaine concentration was 0.030 (0.017-0.071) μg ml-1 (mean [99% confidence interval]) vs 0.095 (0.047-0.208) μg ml-1, and peak total ropivacaine concentration was 0.756 (0.065-1.222) μg ml-1vs 1.695 (0.077-3.005) μg ml-1 for unilateral and bilateral TKA, respectively. The pharmacokinetics was ascribed a one-compartment model with first-order absorption. The main identified covariates were protein binding, allometrically scaled body weight on clearance and volume, and unilateral or bilateral surgery on volume.

CONCLUSIONS: This is the first study to investigate the pharmacokinetics of free and total ropivacaine after unilateral and bilateral TKA. A population model was successfully built and peak free ropivacaine concentration stayed below previously proposed toxic thresholds in patients undergoing unilateral and bilateral TKA receiving LIA with high-dose ropivacaine.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04702282.

OriginalsprogEngelsk
TidsskriftBritish Journal of Anaesthesia
Vol/bind126
Udgave nummer4
Sider (fra-til)872-880
Antal sider9
ISSN0007-0912
DOI
StatusUdgivet - apr. 2021

ID: 61845175