Autologous Blood Transfusion after Local Infiltration Analgesia with Ropivacaine in Total Knee and Hip Arthroplasty
Aims. To study the safety of autotransfusion following local infiltration analgesia (LIA) with ropivacaine. Background. Knowledge of blood concentrations of ropivacaine after LIA and autotransfusion is crucial. However, very limited data are available for toxicological risk assessment. Methods. Auto...
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2012-01-01
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doaj-8bbb71571b774f48aff2921a1c9b5bf52020-11-25T00:52:44ZengHindawi LimitedAnesthesiology Research and Practice1687-69621687-69702012-01-01201210.1155/2012/458795458795Autologous Blood Transfusion after Local Infiltration Analgesia with Ropivacaine in Total Knee and Hip ArthroplastyTorben Breindahl0Ole Simonsen1Peter Hindersson2Bjarne Brødsgaard Dencker3Mogens Brouw Jørgensen4Sten Rasmussen5Department of Clinical Biochemistry, Vendsyssel Hospital, Aalborg University, Bispensgade 37, 9800 Hjørring, DenmarkOrthopaedic Surgery Research Unit, Aalborg Hospital, Aarhus University, Sdr. Skovvej 15, 9000 Aalborg, DenmarkDepartment of Clinical Biochemistry, Vendsyssel Hospital, Aalborg University, Bispensgade 37, 9800 Hjørring, DenmarkDepartment of Anaesthesiology, Vendsyssel Hospital, Aalborg University, Barfredsvej 83, 9900 Frederikshavn, DenmarkOrthopaedic Surgery Research Unit, Aalborg Hospital, Aarhus University, Sdr. Skovvej 15, 9000 Aalborg, DenmarkOrthopaedic Surgery Research Unit, Aalborg Hospital, Aarhus University, Sdr. Skovvej 15, 9000 Aalborg, DenmarkAims. To study the safety of autotransfusion following local infiltration analgesia (LIA) with ropivacaine. Background. Knowledge of blood concentrations of ropivacaine after LIA and autotransfusion is crucial. However, very limited data are available for toxicological risk assessment. Methods. Autotransfusion was studied in patients after total knee arthroplasty (TKA: n=25) and total hip arthroplasty (THA: n=27) with LIA using 200 mg ropivacaine, supplemented with two postoperative bolus injections (150 mg ropivacaine). Drainage blood was reinfused within 6 h postoperatively. Results. Reinfusion caused a significant increase in the serum concentration of total ropivacaine for TKA from 0.54±0.17 (mean ± SD) to 0.79±0.20 μg/mL (P<0.001) and a nonsignificant increase for THA from 0.62±0.17 to 0.63±0.18 μg/mL. The maximum free (unbound) concentration after reinfusion was 0.038 μg/mL. Peak total and free venous ropivacaine concentrations after 8 h and 16 h postoperative bolus injections were 2.6 μg/mL and 0.11 μg/mL, respectively. All concentrations observed were below the threshold for toxicity and no side effects were observed. Conclusion. Autotransfusion of patients undergoing knee or hip arthroplasty after local infiltration analgesia with 200 mg ropivacaine can be performed safely, even supplemented with 8 h and 16 h postoperative bolus injections.http://dx.doi.org/10.1155/2012/458795 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Torben Breindahl Ole Simonsen Peter Hindersson Bjarne Brødsgaard Dencker Mogens Brouw Jørgensen Sten Rasmussen |
spellingShingle |
Torben Breindahl Ole Simonsen Peter Hindersson Bjarne Brødsgaard Dencker Mogens Brouw Jørgensen Sten Rasmussen Autologous Blood Transfusion after Local Infiltration Analgesia with Ropivacaine in Total Knee and Hip Arthroplasty Anesthesiology Research and Practice |
author_facet |
Torben Breindahl Ole Simonsen Peter Hindersson Bjarne Brødsgaard Dencker Mogens Brouw Jørgensen Sten Rasmussen |
author_sort |
Torben Breindahl |
title |
Autologous Blood Transfusion after Local Infiltration Analgesia with Ropivacaine in Total Knee and Hip Arthroplasty |
title_short |
Autologous Blood Transfusion after Local Infiltration Analgesia with Ropivacaine in Total Knee and Hip Arthroplasty |
title_full |
Autologous Blood Transfusion after Local Infiltration Analgesia with Ropivacaine in Total Knee and Hip Arthroplasty |
title_fullStr |
Autologous Blood Transfusion after Local Infiltration Analgesia with Ropivacaine in Total Knee and Hip Arthroplasty |
title_full_unstemmed |
Autologous Blood Transfusion after Local Infiltration Analgesia with Ropivacaine in Total Knee and Hip Arthroplasty |
title_sort |
autologous blood transfusion after local infiltration analgesia with ropivacaine in total knee and hip arthroplasty |
publisher |
Hindawi Limited |
series |
Anesthesiology Research and Practice |
issn |
1687-6962 1687-6970 |
publishDate |
2012-01-01 |
description |
Aims. To study the safety of autotransfusion following local infiltration analgesia (LIA) with ropivacaine. Background. Knowledge of blood concentrations of ropivacaine after LIA and autotransfusion is crucial. However, very limited data are available for toxicological risk assessment. Methods. Autotransfusion was studied in patients after total knee arthroplasty (TKA: n=25) and total hip arthroplasty (THA: n=27) with LIA using 200 mg ropivacaine, supplemented with two postoperative bolus injections (150 mg ropivacaine). Drainage blood was reinfused within 6 h postoperatively. Results. Reinfusion caused a significant increase in the serum concentration of total ropivacaine for TKA from 0.54±0.17 (mean ± SD) to 0.79±0.20 μg/mL (P<0.001) and a nonsignificant increase for THA from 0.62±0.17 to 0.63±0.18 μg/mL. The maximum free (unbound) concentration after reinfusion was 0.038 μg/mL. Peak total and free venous ropivacaine concentrations after 8 h and 16 h postoperative bolus injections were 2.6 μg/mL and 0.11 μg/mL, respectively. All concentrations observed were below the threshold for toxicity and no side effects were observed. Conclusion. Autotransfusion of patients undergoing knee or hip arthroplasty after local infiltration analgesia with 200 mg ropivacaine can be performed safely, even supplemented with 8 h and 16 h postoperative bolus injections. |
url |
http://dx.doi.org/10.1155/2012/458795 |
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