Stringer Bruce W, Singhania Aloke K, Sudhakar Joe E, Brink Rodney B
Barwon Anaesthetic Service, Geelong, Victoria, Australia.
J Arthroplasty. 2007 Sep;22(6):884-92. doi: 10.1016/j.arth.2006.09.004. Epub 2007 Jul 25.
Ropivacaine 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.
在20例髋关节置换术和15例全膝关节置换术中，术中伤口浸润150至200毫升（360 - 400毫克）罗哌卡因后，于术后12小时开始通过关节内疼痛泵输注1000毫克（膝关节）和300毫克（髋关节）罗哌卡因，持续48小时，随后测量罗哌卡因的血液和引流液水平。在疼痛泵增加药物水平之前的最初12小时内，浓度低于2微克/毫升。使用疼痛泵时，罗哌卡因总浓度峰值范围为0.65至4.36微克/毫升。高浸润剂量产生的水平低于或处于1至3微克/毫升的安全阈值范围内。疼痛泵输注产生了一些高于3.0微克/毫升的C（max）水平，但没有毒性的临床证据。伤口引流液量（0.53 - 26.69毫克）表明回输应该是安全的，不过需要进一步研究来证实这一点。
