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Anesth Analg 2003;97:893-897
© 2003 International Anesthesia Research Society

REGIONAL ANESTHESIA

Pulmonary Uptake of Ropivacaine and Levobupivacaine in Rabbits

Shigeo Ohmura, MD, Akiko Sugano, MD, Masayuki Kawada, MD, and Ken Yamamoto, MD

Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan

Address correspondence and reprint requests to Shigeo Ohmura, MD, Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan. Address e-mail to ohmura{at}med.kanazawa-u.ac.jp

Local anesthetic toxicity produced by an inadvertent IV injection is attenuated by the pulmonary uptake of local anesthetics. We compared the pulmonary uptake of ropivacaine and levobupivacaine after a bolus injection in rabbits. Sixteen anesthetized rabbits were randomly assigned to either a ropivacaine group or a levobupivacaine group. A bolus containing ropivacaine or levobupivacaine 0.5 mg/kg and indocyanine green (an intravascular indicator) 0.25 mg/kg was injected rapidly into the vena cava. Arterial blood samples were collected serially at 1.2-s intervals for 30 s. Concentrations of local anesthetic and indocyanine green in each sample were determined for the calculation of first-pass uptake of a local anesthetic in the lung. The first-pass uptake of levobupivacaine (31.4% ± 8.3%; mean ± SD) was larger than that of ropivacaine (22.9% ± 5.6%), and the maximum arterial concentration of ropivacaine (21.2 ± 2.8 µg/mL) was larger than that of levobupivacaine (18.6 ± 1.9 µg/mL). We conclude that the pulmonary uptake of levobupivacaine is larger than that of ropivacaine after a bolus injection. Therefore, the advantages of ropivacaine over levobupivacaine in terms of less cardiovascular toxicity may be offset by the smaller pulmonary uptake after an inadvertent IV injection.

IMPLICATIONS: Local anesthetic toxicity produced by an inadvertent IV injection is attenuated by the pulmonary uptake of local anesthetics. The extent of pulmonary uptake may influence the occurrence of local anesthetic toxicity. We compared the pulmonary uptake of ropivacaine and levobupivacaine after a bolus injection in rabbits.




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S. E. Copeland, L. A. Ladd, X.-Q. Gu, and L. E. Mather
The Effects of General Anesthesia on Whole Body and Regional Pharmacokinetics of Local Anesthetics at Toxic Doses
Anesth. Analg., May 1, 2008; 106(5): 1440 - 1449.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2003 by the International Anesthesia Research Society.