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- Bruce W Stringer, Aloke K Singhania, Joe E Sudhakar, and Rodney B Brink.
- Barwon Anaesthetic Service, Geelong, Victoria, Australia.
- J Arthroplasty. 2007 Sep 1;22(6):884-92.
AbstractRopivacaine blood and drain levels were measured in 20 hip and 15 total knee arthroplasties after intraoperative wound infiltration with 150 to 200 mL (360-400 mg) of ropivacaine, followed by a 48-hour intra-articular pain pump infusion of 1000 mg (knees) and 300 mg (hips) commencing 12 hours postoperatively. Concentrations were below 2 microg/mL over the first 12 hours before the pain pump increased levels. Peak total ropivacaine concentration ranged from 0.65 to 4.36 microg/mL with the pain pump. The high infiltration doses produced levels below or within the safe threshold of 1 to 3 microg/mL. Pain pump infusion produced some C(max) levels above 3.0 microg/mL, but there was no clinical evidence of toxicity. Wound drain amounts (0.53-26.69 mg) indicate reinfusion should be safe, although further study is needed to confirm this.
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