期刊
BRITISH JOURNAL OF ANAESTHESIA
卷 110, 期 6, 页码 996-1000出版社
ELSEVIER SCI LTD
DOI: 10.1093/bja/aet015
关键词
anaesthetic techniques; regional; anaesthetics local; ropivacaine; Caesarean section; toxicity; local anaesthetics
资金
- Department of Anaesthesia, Royal Women's Hospital
- Anaesthesia and Pain Management Unit
- Department of Pharmacology, University of Melbourne
The transversus abdominis plane (TAP) block involves injecting a large volume of local anaesthetic between the muscles of the abdominal wall. Plasma concentrations of ropivacaine after gynaecological laparotomy are potentially high enough to result in systemic toxicity, and there are pharmacokinetic reasons why pregnancy may increase susceptibility to local anaesthetic toxicity. Adult female patients (n30) undergoing elective Caesarean section under spinal anaesthesia received bilateral ultrasound-guided TAP blocks after wound closure (2.5 mg kg(1) of ropivacaine diluted to 40 ml). Venous blood samples were collected at 10, 20, 30, 45, 60, 90, 120, 180 and 240 min following the block. Blood samples were assayed for total and free ropivacaine concentrations. Patients were assessed for symptoms of local anaesthetic toxicity. The mean [standard deviation (sd)] peak total concentration of ropivacaine occurred at 30 min post-injection and was 1.82 (0.69) g ml(1). The maximum detected concentration in any patient was 3.76 g ml(1) (at 10 min post-injection). Three patients reported symptoms of mild neurotoxicity, and the mean (sd) peak levels were elevated in these patients, 2.70 (0.46) g ml(1). TAP blocks can result in elevated plasma ropivacaine concentrations in patients undergoing Caesarean section, which may be associated with neurotoxicity.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据