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BJA Advance Access originally published online on January 22, 2004
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British Journal of Anaesthesia, 2004, Vol. 92, No. 3 416-418
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Short Communications

High plasma ropivacaine concentrations after fascia iliaca compartment block in children

O. Paut*,1, E. Schreiber2, F. Lacroix1, V. Meyrieux1, N. Simon2, T. Lavrut2, J. Camboulives1 and B. Bruguerolle2

1 Department of Paediatric Anaesthesia, Children CHU Timone Hospital, 13385 Marseille Cedex 5, France. 2 Medical and Clinical Pharmacology Department, CHU Timone, 13385 Marseille Cedex 5 France

*Corresponding author. E-mail: olivier.paut@mail.ap-hm.fr

Background. The pharmacokinetic profile of local anaesthetics is influenced by the mode of administration. We sought to compare the pharmacokinetics of two doses of ropivacaine after fascia iliaca compartment (FIC) block in children.

Methods. In this prospective, double-blind study, children received an FIC block as a part of their anaesthetic management during elective orthopaedic surgery on the thigh. They were randomized to receive ropivacaine 0.7 ml kg–1 using either a 0.375% or 0.5% solution. Venous blood samples were drawn up to 6 h after injection. Plasma concentrations of ropivacaine were measured by gas–liquid chromatography.

Results. Six children (10.2 (range 5–15) yr, 35.6 (SD 10) kg were included. FIC block provided satisfactory peroperative pain relief. No signs of toxicity were observed, but high maximal plasma concentrations (Cmax 4.33–5.6 µg ml–1), were observed for three of four patients in the ropivacaine 0.5% group. The two patients in the 0.375% group showed values within the safe range (Cmax 0.66 and 0.98 µg ml–1 respectively). Even though no toxic effects were observed, these results led us to discontinue the study.

Conclusions. The administration of ropivacaine 3.5 mg kg–1 can be associated with sustained high plasma concentrations of ropivacaine, outside the tolerable range. In view of these results, we recommend the use of lower ropivacaine dosage during FIC block in children.

Br J Anaesth 2004: 92: 416–18


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