Assessment of Total Ropivacaine Concentration in Blood after Bilateral Pecto-Intercostal Fascial Block Combined with Rectus Sheath Block in Cardiac Surgery Patients.

IF 0.7 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Surgery Forum Pub Date : 2023-10-17 DOI:10.59958/hsf.6721

Lu Wang, Bailin Jiang, Yi Shi, Boyu Liu, Luyang Jiang, Yi Feng

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引用次数: 0

Abstract

Objectives: Pecto-intercostal fascial block (PIFB) and rectus sheath block (RSB) have been combined to offer better analgesia for cardiac surgery patients, but safety of the analgesic protocol with a large volume of ropivacaine is uncertain.

Methods: This is a prospective observational study at Peking University People's Hospital to investigate the pharmacokinetic profile of ropivacaine after combined regional blocks. Patients undergoing elective cardiac surgery by a median sternotomy were enrolled to receive bilateral PIFB and RSB with 70 mL 0.3% ropivacaine (total dose 210 mg). Blood was sampled at 5, 10, 15, 30, 60, 90 and 120 mins after blocks. Total blood concentration of ropivacaine for patients were measured.

Results: Ten patients were enrolled and analyzed. The peak total ropivacaine concentration varied from 0.67 to 2.42 µg/mL. Time to reach the peak values mainly located between 10 and 30 mins after the performance. No patients had ropivacaine concentration values above toxic threshold (4.3 µg/mL), and there were no systemic toxicity symptoms during the perioperative period.

Conclusions: PIFB combined with RSB in a general injection of 70 mL 0.3% ropivacaine does not give rise to toxic levels, and it is an effective and safe analgesic protocol for cardiac surgery patients.

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心脏外科患者双侧肋间筋膜阻滞联合直肠鞘管阻滞后血液中罗哌卡因总浓度的评估。

目的：胸肋间筋膜阻滞（PIFB）和直肌鞘阻滞（RSB）已被联合使用，为心脏手术患者提供更好的镇痛效果，但使用大容量罗哌卡因的镇痛方案的安全性尚不确定。方法：这是一项在北京大学人民医院进行的前瞻性观察性研究，旨在研究联合区域阻断后罗哌卡因的药代动力学特征。通过正中胸骨切开术接受选择性心脏手术的患者被纳入接受70 mL 0.3%罗哌卡因（总剂量210 mg）的双侧PIFB和RSB。在阻断后5、10、15、30、60、90和120分钟采集血液。测定患者罗哌卡因的总血药浓度。结果：对10例患者进行了入组和分析。罗哌卡因的峰值总浓度在0.67至2.42µg/mL之间。达到峰值的时间主要位于演出后10到30分钟之间。没有患者的罗哌卡因浓度值超过毒性阈值（4.3µg/mL），围手术期也没有出现全身毒性症状。结论：PIFB与RSB联合全身注射70 mL 0.3%罗哌卡因不会产生毒性，是一种有效、安全的心脏手术患者镇痛方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart Surgery Forum 医学-外科

CiteScore

1.20

自引率

16.70%

发文量

130

审稿时长

6-12 weeks

期刊介绍： The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.