Potentially toxic concentrations in blood of total ropivacaine after bilateral transversus abdominis plane blocks; a pharmacokinetic study

Abstract

Elevated blood levels of lidocaine and ropivacaine have been described after transversus abdominis plane (TAP) block. Objective was to investigate the pharmacokinetic profile of ropivacaine after bilateral TAP blocks. Twenty-one adult patients presenting for abdominopelvic surgery with bilateral TAP blocks were enrolled. Ultrasound-guided TAP blocks with bilateral injections of 20ml ropivacaine 0.5 % w/v (total dose 200mg) were performed. Blood was sampled at 0, 10, 30 and 60min after TAP blocks.Total and free peak blood concentrations (Cmax) of Ropivacaine were measured. TAP blocks with bilateral injections of 20ml ropivacaine 0.5 % w/v gave rise to potentially toxic peak blood concentrations of total ropivacaine in one-third of the patients.

Keywords

ropivacaine / toxicity / transversus abdominis plane block

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