Intraindividual and interindividual variability in the disposition of the local anesthetic ropivacaine in healthy subjects. 1997

B M Emanuelsson, and J Persson, and S Sandin, and C Alm, and L L Gustafsson
Clinical Pharmacology, Clinical Research and Development, Astra Pain Control AB, Södertälje, Sweden.

To predict the risk of adverse reactions to local anaesthetics used in clinical practice, it is crucial to know whether any nonlinearity exists in their pharmacokinetics. The disposition of ropivacaine, a new local anesthetic agent, was evaluated in healthy subjects on the basis of plasma levels in the concentration range obtained after regional anaesthesia. Three intravenous doses of ropivacaine hydrochloride (20, 40, and 80 mg) were given in a double-blind, randomized, complete crossover design. Analysis of variance was used to assess the importance of intra- versus interindividual variability in the basic pharmacokinetics. The mean plasma clearance (400 ml/min), volume of distribution at steady state (40 l), and terminal half-life (1.7 h) were similar, irrespective of dose. The intersubject variability for these parameters was higher than the intrasubject variability. A slight increase in free fraction (15%) with increasing dose might indicate that the lower limit for saturation of protein binding may be reached at the higher plasma levels. One subject (80 mg) reported numbness of the lower lip 2 min after the end of the infusion, which may be a sign of systemic CNS toxicity. The total and free plasma concentration was extrapolated to 1.7 and 0.08 mg/l, respectively.

UI MeSH Term Description Entries
D007275 Injections, Intravenous Injections made into a vein for therapeutic or experimental purposes. Intravenous Injections,Injection, Intravenous,Intravenous Injection
D008297 Male Males
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077212 Ropivacaine An anilide used as a long-acting local anesthetic. It has a differential blocking effect on sensory and motor neurons. 1-Propyl-2',6'-pipecoloxylidide,AL 381,AL-381,LEA 103,LEA-103,Naropeine,Naropin,Ropivacaine Hydrochloride,Ropivacaine Monohydrochloride,Ropivacaine Monohydrochloride, (S)-isomer,1 Propyl 2',6' pipecoloxylidide,AL381,LEA103
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000577 Amides Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed) Amide
D000779 Anesthetics, Local Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate. Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics

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