Pharmacokinetics of the local anesthetic ropivacaine after transversus abdominis plane block in healthy volunteers

Latzke, D.; Marhofer, Peter; Kettner, Stephan C.; Koppatz, Karl; Turnheim, Klaus; Lackner, Edith; Sauermann, Robert; Müller, Markus; Zeitlinger, Markus

doi:10.1007/s00228-011-1139-8

Cited by 42 publications

(33 citation statements)

References 23 publications

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“…This is consistent with other findings of blood drug levels during TAPB and RSB 12,13,15,16 and is probably attributable to anatomical differences. During lateral TAPB, an administered drug is completely surrounded by the transversus abdominis and the internal oblique muscles, whereas the drug solution is only in contact with the dorsal side of the rectus abdominis muscle during RSB.…”

Section: Discussionsupporting

confidence: 93%

Chronological Changes in Ropivacaine Concentration and Analgesic Effects Between Transversus Abdominis Plane Block and Rectus Sheath Block

Murouchi

Iwasaki

Yamakage

2015

Regional Anesthesia and Pain Medicine

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Section: Discussionsupporting

confidence: 93%

Chronological Changes in Ropivacaine Concentration and Analgesic Effects Between Transversus Abdominis Plane Block and Rectus Sheath Block

Murouchi

Iwasaki

Yamakage

2015

Regional Anesthesia and Pain Medicine

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“…4Y10 Because the mechanism of the somatic analgesic effect of the various TAP blocks has not been completely elucidated, much research is currently directed in this area. 11,12 A recent anatomic study described the course of the nerves of the anterior abdominal wall based on a thorough cadaveric dissection. 13 Three large branch communications were described in: (i) a plexus positioned anteriorly (the intercostal plexus), (ii) a plexus positioned adjacent to the deep circumflex iliac artery (the TAP plexus), and (iii) a plexus positioned adjacent to the deep inferior epigastric artery (the rectus sheath plexus).…”

mentioning

confidence: 99%

Distribution Patterns, Dermatomal Anesthesia, and Ropivacaine Serum Concentrations After Bilateral Dual Transversus Abdominis Plane Block

Børglum

Jensen²,

Christensen

et al. 2012

Regional Anesthesia and Pain Medicine

142

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“…Griffiths et al [20] reported that 3 mg•kg −1 of ropivacaine administered by TAP blocks in adult female patients resulted in potentially toxic plasma concentrations with the peak concentration occurring 30 min post-injection. Latzke et al [21] demonstrated that a time to the maximum concentration of plasma ropivaine was 0.44 ± 0.36 h (mean ± SD) after injection in 8 healthy volunteers administered 150 mg ropivacaine by TAP block. However, neither signs of neurotoxicity [22] nor cardiovascular instability were detected in our case.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Apnea Induced by Fentanyl and Other Multiple Respiratory-Modulating Factors

Matsuda¹,

Sato²

2014

OJAnes

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Purpose: Opioids are concerned as a major cause of postoperative respiratory depression. In the immediate postoperative period, however, other factors can produce instability of breathing such as pain, agitation, and residual effects of anesthetics. Such factors might be overlooked masked by the fear for opioid-induced respiratory depression. We report a case who presented apnea immediately after emergence from anesthesia that we considered was produced by an interaction among such factors accompanied with fentanyl-induced respiratory depression. Clinical Features: A 31-year-old woman underwent ovarian cystectomy under general anesthesia with continuous infusions of propofol and remifentanil, and bolus doses of fentanyl. Transversus abdominis plane blocks with ropivacaine were given upon completion of surgery. She complained of severe wound pain and was agitated at the emergence from anesthesia. Fentanyl 50 µg was administered intravenously. In several minutes, she developed apnea, unconsciousness, and difficulty of mechanical ventilation via a face mask. The estimated effect site concentration at the onset of the episode (2.9 ng•ml −1 ) was approximately the same (3.0 ng•ml −1 ) as after 30 min when she regained consciousness and spontaneous breathing. It indicated that not only direct inhibition of the respiratory center by fentanyl but also other stimulatory and inhibitory factors contributed to respiratory arrest. Conclusion: In the immediate postoperative period, transient factors, such as pain, mental instability and anesthetic residues, which are indirectly-related with breathing, can interact each other and with opioids. The interaction would induce apnea through mechanisms combined among direct inhibition of the respiratory center, and modulation of chemical and cortical controls of breathing.

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Pharmacokinetics of the local anesthetic ropivacaine after transversus abdominis plane block in healthy volunteers

Abstract: While the systemic pharmacokinetics was comparable between subjects, the local distribution of ropivacaine was highly variable after TAP block.

Cited by 42 publications

References 23 publications

Chronological Changes in Ropivacaine Concentration and Analgesic Effects Between Transversus Abdominis Plane Block and Rectus Sheath Block

Chronological Changes in Ropivacaine Concentration and Analgesic Effects Between Transversus Abdominis Plane Block and Rectus Sheath Block

Distribution Patterns, Dermatomal Anesthesia, and Ropivacaine Serum Concentrations After Bilateral Dual Transversus Abdominis Plane Block

Postoperative Apnea Induced by Fentanyl and Other Multiple Respiratory-Modulating Factors

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