Effects of age factors on pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block
10.3760/cma.j.issn.0254-1416.2016.07.017
- VernacularTitle:年龄因素对患者腰丛联合坐骨神经阻滞时罗哌卡因药代动力学的影响
- Author:
Jiaojiao DONG
;
Shishi ZHAO
;
Shengxian LIN
;
Limei CHEN
;
Quanguang WANG
;
Xuzhong XU
- Publication Type:Journal Article
- Keywords:
Age factor;
Amides;
Pharmacokinetics;
Lumbosacral plexus;
Sciatic nerve;
Neuromuscular blockade
- From:
Chinese Journal of Anesthesiology
2016;36(7):839-842
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of age factors on the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block in patients.Methods Twenty patients of both sexes,aged ≥ 18 yr,weighing 50-75 kg,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,scheduled for elective lower extremity surgery,were divided into 2 groups (n=10 each) according to age:young and middle-aged group (18-59 yr) and elderly group (≥ 60 yr).Combined lumbar plexus-sciatic never block was performed using an ultrasonic instrument and a nerve stimulator.Lumbar plexus block was performed with 0.5％ ropivacaine 30 ml.Sciatic never block was performed with 2％ lidocaine 10 ml plus 0.75％ ropivacaine 10 ml.Before administration and at 5,10,15,20,30,45,60,120,180 and 360 min after administration,blood samples were collected from the radial artery for determination of the blood concentration of ropivacaine by high-performance liquid chromatography.The area under the concentrationtime curve,maximum concentration (Cmax),time to C terminal elimination half-life and clearance were calculated.Results Compared with young and middle-aged group,the blood concentration of ropivacaine was significantly decreased at 5-45 min after administration,the Cmax was significantly decreased,terminal elimination half-life was significantly prolonged (P＜0.05),and no significant change was found in area under the concentration-time curve,the time to C and clearance in elderly group (P＞ 0.05).Conclusion Age factors can affect the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block,and both absorption and metabolism of ropivacaine are slower in elderly patients than in young and middle-aged patients.
