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British Journal of Anaesthesia, 2000, Vol. 85, No. 6 830-835
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Ropivacaine plasma concentrations during 120-hour epidural infusion

D. Wiedemann1, B. Mühlnickel1, E. Staroske1, W. Neumann2 and W. Röse *,1

1Department of Anaesthesiology and Critical Care Medicine and 2Department of Orthopaedic Surgery, Otto von Guericke University, Magdeburg, Germany*Corresponding author

The pharmacokinetics of ropivacaine were evaluated during long-term continuous epidural analgesia (CEDA) for about 120 h. The total and free plasma concentrations of ropivacaine and the {alpha}1-acid glycoprotein (AAG) concentration were measured in 12 patients after total knee arthroplasty. The infusion rate was adjusted according to patients’ analgesic needs or side effects. The mean (SD) rate of infusion of ropivacaine (Naropin 2 mg ml–1) was 14.6 (3.2) mg h–1 on the day of surgery and was increased after surgery to 15.4 (4.4) mg h–1 on days 1–5. This was equivalent to an absolute dose of 1786 (553) mg of ropivacaine over the entire infusion period. After an initial increase, the mean free ropivacaine plasma concentration nearly plateaued and than decreased slightly after approximately 70 h. The individual peak free plasma concentration was 0.096 (0.034) µg ml–1. The highest individual free plasma concentration was 0.16 µg ml–1. The individual peak total plasma concentration, 4.1 (1.2) µg ml–1, was achieved after 67.7 (16.5) h, although the AAG concentration increased throughout the observation period. Our data support the safety and efficacy of long-term ropivacaine CEDA.

Br J Anaesth 2000; 85: 830–5


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