Total systemic ropivacaine concentrations following aerosolized intraperitoneal delivery using the AeroSurge

Study Objective: To evaluate intraperitoneal ropivacaine delivery with the AeroSurge device in the clinical setting and to evaluate the total systemic ropivacaine levels achieved following delivery of 50 mg of aerosolized ropivacaine. Design: Preliminary, prospective, nonrandomized study. Setting: Operating room of a university hospital. Patients: 5 consecutive ASA physical status 1 and 2 patients undergoing elective laparoscopic Nissen fundoplication or cholecystectomy. Intervention: Five mL of 1% ropivacaine was delivered through the 10 mm port using the AeroSurge device at peritoneal insufflation. Measurements: Venous blood samples were collected and total ropivacaine concentration was determined using liquid chromatography-mass spectrometry. Main Results: The AeroSurge device delivered ropivacaine, visible as mist within the peritoneal cavity. Peak concentration (C-max) was attained between 10 and 30 minutes following the end of aerosolized ropivacaine delivery. At no stage did any level approach toxic levels. Conclusions: This preliminary study confirms that, aerosolized intraperitoneal local anesthetic is feasible, with ropivacaine concentrations remaining within safe levels. (C) 2014 Elsevier Inc. All rights reserved.