Ailbhe M McDermott1, Kah Hoong Chang2, Kelly Mieske2, Abdelaly Abeidi3, Brian H Harte4, Michael J Kerin2, Oliver J McAnena2. 1. Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland. Electronic address: ailbhemcdermott@gmail.com. 2. Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland. 3. Department of Anesthesia, Galway Clinic, Doughiska, Galway, Ireland. 4. Department of Anesthesia, Galway Clinic, Doughiska, Galway, Ireland; Department of Anesthesia, University Hospital Galway, Galway, Ireland.
Abstract
STUDY OBJECTIVE: To evaluate intraperitoneal ropivacaine delivery with the AeroSurge device in the clinical setting and to evaluate the total systemic ropivacaine levels achieved following delivery of 50 mg of aerosolized ropivacaine. DESIGN: Preliminary, prospective, nonrandomized study. SETTING: Operating room of a university hospital. PATIENTS: 5 consecutive ASA physical status 1 and 2 patients undergoing elective laparoscopic Nissen fundoplication or cholecystectomy. INTERVENTION: Five mL of 1% ropivacaine was delivered through the 10 mm port using the AeroSurge device at peritoneal insufflation. MEASUREMENTS: Venous blood samples were collected and total ropivacaine concentration was determined using liquid chromatography-mass spectrometry. MAIN RESULTS: The AeroSurge device delivered ropivacaine, visible as mist within the peritoneal cavity. Peak concentration (Cmax) was attained between 10 and 30 minutes following the end of aerosolized ropivacaine delivery. At no stage did any level approach toxic levels. CONCLUSIONS: This preliminary study confirms that aerosolized intraperitoneal local anesthetic is feasible, with ropivacaine concentrations remaining within safe levels.
STUDY OBJECTIVE: To evaluate intraperitoneal ropivacaine delivery with the AeroSurge device in the clinical setting and to evaluate the total systemic ropivacaine levels achieved following delivery of 50 mg of aerosolized ropivacaine. DESIGN: Preliminary, prospective, nonrandomized study. SETTING: Operating room of a university hospital. PATIENTS: 5 consecutive ASA physical status 1 and 2 patients undergoing elective laparoscopic Nissen fundoplication or cholecystectomy. INTERVENTION: Five mL of 1% ropivacaine was delivered through the 10 mm port using the AeroSurge device at peritoneal insufflation. MEASUREMENTS: Venous blood samples were collected and total ropivacaine concentration was determined using liquid chromatography-mass spectrometry. MAIN RESULTS: The AeroSurge device delivered ropivacaine, visible as mist within the peritoneal cavity. Peak concentration (Cmax) was attained between 10 and 30 minutes following the end of aerosolized ropivacaine delivery. At no stage did any level approach toxic levels. CONCLUSIONS: This preliminary study confirms that aerosolized intraperitoneal local anesthetic is feasible, with ropivacaine concentrations remaining within safe levels.
Authors: Ailbhe M McDermott; Kah Hoong Chang; Kelly Mieske; Peter F McAnena; Brian Kinirons; Abdelaly Abeidi; Brian H Harte; Michael J Kerin; Oliver J McAnena Journal: World J Surg Date: 2015-07 Impact factor: 3.352