Total systemic ropivacaine concentrations following aerosolized intraperitoneal delivery using the AeroSurge

McDermott, Ailbhe M.; Chang, Kah Hoong; Mieske, Kelly; Abeidi, Abdelaly; Harte, B. H.; Kerin, Michael J.; McAnena, O. J.

doi:10.1016/j.jclinane.2013.07.013

Cited by 10 publications

(8 citation statements)

References 27 publications

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“…The plasma concentrations remained consistent under the mean toxic plasma concentration described in healthy volunteers (4.3 mg/L, range 3.4–5.3 mg/L) [23]. Our data are similar to those of previous animal and human studies [16, 17]. …”

Section: Discussionsupporting

confidence: 90%

“…Visceral pain is poorly discriminated and involves the entire abdomen or is referred to as the shoulder due to irritation of the diaphragmatic peritoneum. As in previous studies, the nebulization of ropivacaine was able to prevent shoulder pain considerably [16, 18, 19]. …”

Section: Discussionsupporting

confidence: 65%

“…Human studies have confirmed favorable pharmacokinetics and pharmacodynamics of nebulized ropivacaine. Peak concentration is attained between 10 and 30 minutes following the end of aerosolized ropivacaine delivery and the plasma concentration of local anesthetics remained within safe levels even after nebulization of 3 mg/kg of ropivacaine [16]. However, the delivery of high doses of ropivacaine (i.e., 3 mg/kg) may be unnecessary or even impractical due to the long nebulization time with the actual commercially available systems.…”

Section: Introductionmentioning

confidence: 99%

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Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study

Allegri

Ornaghi

Ferland

et al. 2017

Pain Research and Management

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Background. Intraperitoneal nebulization of ropivacaine reduces postoperative pain and morphine consumption after laparoscopic surgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and dose-related absorption of ropivacaine when nebulized in the peritoneal cavity during laparoscopic cholecystectomy. Methods. Patients were randomized to receive 50, 100, or 150 mg of ropivacaine 1% by peritoneal nebulization through a nebulizer. Morphine consumption, pain intensity in the abdomen, wound and shoulder, time to unassisted ambulation, discharge time, and adverse effects were collected during the first 48 hours after surgery. The pharmacokinetics of ropivacaine was evaluated using high performance liquid chromatography. Results. Nebulization of 50 mg of ropivacaine had the same effect of 100 or 150 mg in terms of postoperative morphine consumption, shoulder pain, postoperative nausea and vomiting, activity resumption, and hospital discharge timing (>0.05). Plasma concentrations did not reach toxic levels in any patient, and no significant differences were observed between groups (P > 0.05). Conclusions. There is no enhancement in analgesic efficacy with higher doses of nebulized ropivacaine during laparoscopic cholecystectomy. When administered with a microvibration-based aerosol humidification system, the pharmacokinetics of ropivacaine is constant and maintains an adequate safety profile for each dosage tested.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study

Allegri

Ornaghi

Ferland

et al. 2017

Pain Research and Management

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“…However, studies have shown the serum drug levels of local anaesthetics like ropivacaine to be well below toxic levels. 19 …”

Section: Discussionmentioning

confidence: 99%

A Randomized Double-Blind Study Evaluating Intraperitoneal Ropivacaine Nebulization With and Without Nalbuphine for Post-operative Analgesia in Laparoscopic Cholecystectomy

Gowda

Govil

Kumar

et al. 2022

Turk J Anaesthesiol Reanim

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Objective: Local anaesthetics administered into the peritoneal cavity have been successfully used for post-operative pain relief in minimally invasive laparoscopic procedures. We intended to study and compare nebulized intraperitoneal ropivacaine with and without nalbuphine, with a placebo for post-operative pain relief in these surgeries. Methods: A prospective, randomized double-blinded study was conducted over a period of 1 year after institutional ethical clearance, in patients undergoing elective laparoscopic cholecystectomy. Subjects were randomized into 3 groups (S: saline, R: ropivacaine, RN: ropivacaine plus nalbuphine). The pain was assessed in the post-operative period using NRS scores (up to 24 hours). Kruskal-Wallis test was used for comparison, P < .05 was considered significant. Time to first rescue analgesia, total opioid requirement, and side effects were also recorded. Results: Groups were similar in terms of demographic data. Patients in the placebo group reported higher NRS scores than the other 2 study groups till 4 hours post-operative (earlier rescue analgesia). The addition of nalbuphine did not cause any statistically significant improvement in post-operative pain relief (NRS) as compared to ropivacaine administered alone. Intraperitoneal ropivacaine nebulization had no significant adverse effect as compared to placebo. Conclusions: Ropivacaine nebulization with or without nalbuphine is more effective than placebo for post-operative pain relief after laparoscopic cholecystectomy without significant side effects. Addition of nalbuphine to ropivacaine nebulization does not significantly improve pain relief after laparoscopic cholecystectomy.

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“…Ropivacaine is the preferred local anesthetic in adults because of its long duration, and reduced CNS toxicity and cardiotoxic potential compared to bupivacaine . Some studies have shown that intraperitoneal ropivacaine (the maximum safe dose is 3–4 mg·kg −1 ) is safe with a similar pharmacokinetic profile to that of extravascular administration . In Callesen's study, a total dose about 4 mg·kg −1 of ropivacaine was used for combined field block and i.p.…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal ropivacaine and early postoperative pain and postsurgical outcomes after laparoscopic herniorrhaphy in toddlers: a randomized clinical trial

Tian

Yang

et al. 2016

Pediatric Anesthesia

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Total systemic ropivacaine concentrations following aerosolized intraperitoneal delivery using the AeroSurge

Cited by 10 publications

References 27 publications

Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study

Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study

A Randomized Double-Blind Study Evaluating Intraperitoneal Ropivacaine Nebulization With and Without Nalbuphine for Post-operative Analgesia in Laparoscopic Cholecystectomy

Intraperitoneal ropivacaine and early postoperative pain and postsurgical outcomes after laparoscopic herniorrhaphy in toddlers: a randomized clinical trial

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