Journal of Anesthesia

, Volume 29, Issue 1, pp 146–148 | Cite as

Plasma ropivacaine concentration following ultrasound-guided subcostal transversus abdominis plane block in adults

  • Kazuya TojuEmail author
  • Katsunori Shiraishi
  • Takahiro Hakozaki
  • Tsuyoshi Isosu
  • Masahiro Murakawa
Short Communication


Ultrasound-guided subcostal transversus abdominis plane block (TAPB) is widely used for abdominal surgery; however, arterial plasma concentration of the anesthetic ropivacaine after the blockade is still unclear. We evaluated ropivacaine concentration after subcostal TAPB in adult patients undergoing upper abdominal surgery. Twelve patients with American Society of Anesthesiologists physical status 1–2 were enrolled. They received ultrasound-guided subcostal TAPB with 0.45 % ropivacaine at 3 mg/kg. Arterial plasma samples were collected at 15, 30, 45, 60, 90, and 120 min after the blockade and analyzed for total ropivacaine concentration using liquid chromatography and mass spectrometry. At every time point, the maximum concentrations (C max), and time to the C max (T max) were recorded. The mean C max and T max were 1.87 (0.78) µg/ml and 31.3 (16.7) min, respectively. No adverse events or clinical symptoms indicating systemic toxicity were observed during this study. The study demonstrated that administration of ropivacaine at 3 mg/kg during subcostal TAPB led to rapid increases in plasma concentration of the anesthetic during the first 2 h after the blockade. C max nearly reached the threshold for systemic toxicity.


Ultrasound Transversus abdominis plane block Ropivacaine 


  1. 1.
    Niraj G, Kelkar A, Jeyapalan I, Graff-Baker P, Williams O, Darbar A, Maheshwaran A, Powell R. Comparison of analgesic efficacy of subcostal transversus abdominis plane blocks with epidural analgesia following upper abdominal surgery. Anaesthesia. 2011;66:465–71.CrossRefPubMedGoogle Scholar
  2. 2.
    Griffiths JD, Barron FA, Grant S, Bjorksten AR, Hebbard P, Royse CF. Plasma ropivacaine concentrations after ultrasound-guided transversus abdominis plane block. Br J Anaesth. 2010;105:853–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Karmakar MK, Ho AMH, Law BK, Wong ASY, Shafer SL, Gin T. Arterial and venous pharmacokinetics of ropivacaine with and without epinephrine after thoracic paravertbral block. Anesthesiology. 2005;103:704–11.CrossRefPubMedGoogle Scholar
  4. 4.
    Hebbard P. Subcostal transversus abdominis plane block under ultrasound guidance. Anesth Analg. 2008;106:674–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Vanterpool S, Steele SM, Nielsen KC, Tucker M, Klein SM. Combined lumbar-plexus and sciatic-nerve blocks: an analysis of plasma ropivacaine concentrations. Reg Anesth Pain Med. 2006;31:417–21.PubMedGoogle Scholar
  6. 6.
    Wulf H, Behnke H, Vogel I, Schröder J. Clinical usefulness, safety, and plasma concentration of ropivacaine 0.5% for inguinal hernia repair in regional anesthesia. Reg Anesth Pain Med. 2001;26:348–51.CrossRefPubMedGoogle Scholar
  7. 7.
    Paut O, Schreiber E, Lacroix F, Meyrieux V, Simon N, Lavrut T. High plasma ropivacaine concentrations after fascia iliaca compartment block in children. Br J Anaesth. 2004;92:416–8.CrossRefPubMedGoogle Scholar
  8. 8.
    McCartney CJ, Murphy DB, Iagounova A, Chan VW. Intravenous ropivacaine bolus is a reliable marker of intravascular injection in premedicated healthy volunteers. Can J Anesth. 2003;50:795–800.CrossRefPubMedGoogle Scholar
  9. 9.
    Knudsen K, Beckman Suukula M, Blomberg S, Sjovall J, Edvardsson N. Central nervous and cardiovascular effects of i.v. infusions of ropivacaine, bupivacaine and placebo in volunteers. Br J Anaesth. 1997;78:507–14.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Anesthesiologists 2014

Authors and Affiliations

  • Kazuya Toju
    • 1
    Email author
  • Katsunori Shiraishi
    • 2
  • Takahiro Hakozaki
    • 1
  • Tsuyoshi Isosu
    • 1
  • Masahiro Murakawa
    • 1
  1. 1.Department of AnesthesiologyFukushima Medical University School of MedicineFukushima cityJapan
  2. 2.Department of AnesthesiologyFukushima Prefectural Aizu General HospitalFukushimaJapan

Personalised recommendations