Department of Clinical Pharmacology, Division of Clinical Pharmacokinetics and Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Eur J Clin Pharmacol. 2012 Apr;68(4):419-25. doi: 10.1007/s00228-011-1139-8. Epub 2011 Oct 27.
The transversus abdominis plane (TAP) block is a regional anesthetic technique used for pain control following abdominal surgical procedures. While a minimum of systemic side effects is usually expected after local anesthesia, it is unknown to which extent systemic absorption and redistribution to the abdominal wall contributes to the effects of anesthetics. The aim of this study was to determine concentration-time profiles of ropivacaine after the injection of 150 mg of ropivacaine into the lateral abdominal wall in various compartments.
The microdialysis technique was used to measure ropivacaine in plasma as well as at abdominal wall sites cranial from the injection site (below the 12th rip) and caudal from the injection site (cranial from the iliac crest) and in the skeletal muscle tissue of the contra lateral thigh of eight healthy volunteers.
The mean exposure to ropivacaine measured as the area under the concentration-time curve was significantly higher at the two abdominal sites (240.9 ± 409.1 and 86.18 ± 133.50 μg h/mL, respectively) than in plasma (5.1 ± 1.0 μg h/mL) or in peripheral tissue (1.1 ± 1.2 μg h/mL). While the high mean concentrations of ropivacaine measured at the abdominal wall sites support the topical concept of the TAP block, the observed variability was striking.
While the systemic pharmacokinetics was comparable between subjects, the local distribution of ropivacaine was highly variable after TAP block.
腹横肌平面（TAP）阻滞是一种用于腹部手术后疼痛控制的区域麻醉技术。虽然局部麻醉后通常预期全身副作用最小，但全身吸收和重新分布到腹壁对麻醉效果的影响程度尚不清楚。本研究的目的是确定在外侧腹壁注射 150mg 罗哌卡因后罗哌卡因的浓度-时间曲线在不同部位的分布。
采用微透析技术测量 8 名健康志愿者血浆中以及注射部位上方（第 12 肋以下）和下方（髂嵴以上）腹部壁位以及对侧大腿骨骼肌组织中罗哌卡因的浓度。
以浓度-时间曲线下面积（AUC）表示的罗哌卡因平均暴露量在两个腹部部位（分别为 240.9±409.1μg·h/mL 和 86.18±133.50μg·h/mL）明显高于血浆（5.1±1.0μg·h/mL）或外周组织（1.1±1.2μg·h/mL）。虽然在腹壁部位测量到的罗哌卡因高平均浓度支持 TAP 阻滞的局部作用概念，但观察到的变异性非常显著。
尽管 TAP 阻滞的全身药代动力学在个体之间具有可比性，但罗哌卡因的局部分布高度可变。
