Plasma ropivacaine concentrations after ultrasound-guided transversus abdominis plane block

Abstract

Transversus abdominus plane block using 3 mg kg(-1) of ropivacaine produces venous plasma concentrations that are potentially neurotoxic, although broadly consistent with plasma levels found after injection at other comparable sites.

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

“…In an intravenous titration study involving healthy volunteers, the onset of minor neurological symptoms was observed at a mean total plasma ropivacaine concentration of 2.2 μg/mL, i.e., at a level comparable to the mean C max in plasma of 1.88± 0.37 μg/mL observed in our subjects [21]. Griffiths et al previously described similar C max values in plasma of 2.54± 0.75 μg/mL following the administration of 3 mg/kg body weight ropivacaine [22]. However, while their study investigated only female subjects with a median age of 43 years, only male, young volunteers were included in our study.…”

Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia

“…In one study, it was shown that 3 mg kg -1 of ropivacaine in the TAP block in adult women resulted in potentially toxic plasma concentrations. A relatively high dose of ropivacaine was used in that study and the volume of local anesthetics injected at each site was 20 mL [19]. In our study, we used a low volume and low concentration of bupivacaine successfully; the total dose of the injected bupivacaine was 75 mg.…”

Eficácia analgésica do bloqueio ecoguiado do plano transverso do abdome – revisão sistemática

“…A falta de ECR que comparem o desempenho pré-operatório ou pós-operatório do TAP para o mesmo procedimento cirúrgico torna impossí-vel a recomendação do tempo adequado para o bloqueio. Em comparação com o TAP concentrações diferentes 30,36 não demonstraram qualquer benefício no uso de uma dose mais elevada e, por causa dos potenciais efeitos tóxicos da AL no TAP e a possível superação de doses tóxicas, como Griffiths et al 60 demonstraram com doses de ropivacaína usadas habitualmente, se faz necessário o estudo das doses mínimas eficazes para reduzir os possíveis efeitos deletérios da AL.…”