Systemic Ropivacaine Diminishes Pain Sensitization Processes: A Randomized, Double-Blinded, Placebo-Controlled, Crossover Study in Healthy Volunteers

Introduction: Ropivacaine is a local anesthetic widely used for regional anesthesia. One of its advantages is low toxicity at plasma concentrations reached systemically during continuous peripheral or central nervous block. The objective of this study was to test the effect of systemic ropivacaine on pain, hyperalgesia, dynamic allodynia, and flare response. Methods: This randomized, double-blinded, placebo-controlled, crossover study was carried out in at the Clinical Trials Centre, University of Zurich, Switzerland. Twenty healthy male volunteers were included in the study. Exclusion criteria were contraindications or hypersensitivity to local anesthetics, vulnerable subjects (intellectually or mental impaired), drug, alcohol or nicotine abuse, known peripheral neuropathies, diabetes mellitus and/or congestive heart disease. Ropivacaine and saline were infused intravenously during a subcutaneous electrical stimulation. The stimulation software adjusted the stimulus strength according to the rating on a numeric rating scale (NRS; 0-10) maintaining a NRS of 5. Areas of punctate hyperalgesia, dynamic allodynia, and flare response were measured before and after the infusion. Results: The area of hyperalgesia increased significantly with saline (303 +/- 380%, P<0.05) and ropivacaine (186 +/- 137%, P<0.05). The area of allodynia (253 +/- 299%, P<0.05) and flare response (112 +/- 24%, P<0.05) increased only during the placebo infusion. Conclusion: The results of this study imply that systemic ropivacaine may diminish pain sensitization processes.