• Bregje J W Thomassen, Laurens Pool, Rudolf Van Der Flier, Rudolf Stienstra, and Bastiaan A in 't Veld.
• Department of Orthopaedic Surgery, Medical Center Haaglanden, The Hague, The Netherlands. b.thomassen@mchaaglanden.nl
• Acta Orthop Belg. 2012 Aug 1; 78 (4): 506-11.

AbstractWe investigated the safety of LIA (local infiltration analgesia) combined with retransfusion of drained blood. Total knee arthroplasty patients received two peri-articular injections during surgery followed by continuous infusion, both with ropivacaine (567 mg). Ropivacaine plasma concentrations were determined in blood samples taken at 0, 3, 6 and 24 hours postoperatively. The collected shed blood was not retransfused, instead retransfusion was modelled by estimating the cumulative plasma concentrations at 6 hours postoperative. Total and unbound ropivacaine plasma concentrations ranged respectively from 0.08 to 1.9 mg/L and 0.003 to 0.11 mg/L. An average of 13.1 +/- 3.7 mg unbound ropivacaine would have been returned to the patient. The estimated cumulative ropivacaine plasma levels showed that instant retransfusion would have led to plasma levels below 0.26 mg/L. It appears to be safe to transfuse autologous blood in combination with LIA. However, before drawing definite conclusions formal measurement of actual concentrations is required.

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