{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T19:26:21Z","timestamp":1783625181406,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,1,9]],"date-time":"2017-01-09T00:00:00Z","timestamp":1483920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Sint Maartenskliniek"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although considered safe, no pharmacokinetic data of high dose, high volume local infiltration analgesia (LIA) with ropivacaine without the use of a surgical drain or intra\u2010articular catheter have been described. The purpose of this study is to describe the maximum total and unbound ropivacaine concentrations (<jats:italic>C<\/jats:italic><jats:sub>max<\/jats:sub>, <jats:italic>C<\/jats:italic><jats:sub>u max<\/jats:sub>) and corresponding maximum times (<jats:italic>T<\/jats:italic><jats:sub>max<\/jats:sub>, <jats:italic>T<\/jats:italic><jats:sub>u max<\/jats:sub>) of a single\u2010shot ropivacaine (200 ml 0.2%) and 0.75 mg epinephrine (1000 \u03bcg\/ml) when used for LIA in patients for total knee arthroplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cohort study, 20 patients were treated with LIA of the knee for primary total knee arthroplasty. Plasma samples were taken at 20, 40, 60, 90, 120, 240, 360 min and at 24 h after tourniquet release, in which total and unbound ropivacaine concentrations were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Results are given as median [IQR]. Highest ropivacaine concentration (<jats:italic>C<\/jats:italic><jats:sub>max<\/jats:sub>) was 1.06 \u03bcg\/ml [0.34]; highest unbound ropivacaine concentration (<jats:italic>C<\/jats:italic><jats:sub>u max<\/jats:sub>) was 0.09 \u03bcg\/ml [0.05]. The corresponding time to reach the maximum concentration for total ropivacaine was 312 min [120] after tourniquet release, and for the unbound fraction 265 [110] min after tourniquet release.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although great inter\u2010individual variability was found between the maximum ropivacaine concentrations, both maximum total and unbound serum concentrations of ropivacaine remained well below the assumed systemic toxic thresholds of 4.3 and 0.56 \u03bcg\/ml.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12849","type":"journal-article","created":{"date-parts":[[2017,1,9]],"date-time":"2017-01-09T07:22:48Z","timestamp":1483946568000},"page":"338-345","source":"Crossref","is-referenced-by-count":29,"title":["Pharmacokinetics of 400 mg ropivacaine after periarticular local infiltration analgesia for total knee arthroplasty"],"prefix":"10.1111","volume":"61","author":[{"given":"M. G. E.","family":"Fenten","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Sint Maartenskliniek Nijmegen The Netherlands"},{"name":"Department of Anesthesiology, Pain and Palliative Care Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. M. K.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Sint Maartenskliniek Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. J.","family":"Touw","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Pharmacology University Medical Center Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. J. F.","family":"van den Bemt","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Sint Maartenskliniek Nijmegen The Netherlands"},{"name":"Department of Clinical Pharmacy Radboud University Medical Center Nijmegen The Netherlands"},{"name":"Department of Clinical Pharmacy and Toxicology Maastricht University Medical Center+ Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. J.","family":"Scheffer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pain and Palliative Care Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. J. C.","family":"Heesterbeek","sequence":"additional","affiliation":[{"name":"Research Department Sint Maartenskliniek  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Stienstra","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Sint Maartenskliniek Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-009-0940-7"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e318296b6a0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453670710014950"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2008.01777.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu155"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2011.03692.x"},{"key":"e_1_2_6_8_1","unstructured":"Naropin 2 mg\/ml solution for infusion \u2010 Summary of Product Characteristics (SPC) \u2010 (eMC).2015. 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