Vol 6, No 2 (2012)

Elevated blood levels of lidocaine and ropivacaine have been described after transversus abdominis plane (TAP) block. Objective was to investigate the pharmacokinetic profile of ropivacaine after bilateral TAP blocks. Twenty-one adult patients presenting for abdominopelvic surgery with bilateral TAP blocks were enrolled. Ultrasound-guided TAP blocks with bilateral injections of 20ml ropivacaine 0.5 % w/v (total dose 200mg) were performed. Blood was sampled at 0, 10, 30 and 60min after TAP blocks.Total and free peak blood concentrations (Cmax) of Ropivacaine were measured. TAP blocks with bilateral injections of 20ml ropivacaine 0.5 % w/v gave rise to potentially toxic peak blood concentrations of total ropivacaine in one-third of the patients.

The article presents data on the early postoperative period in 75 patients with trauma of the distal lower extremities, depending on the type of anesthetic management. We compared patients with isolated spinal anesthesia, patients with spinal anesthesia combined with local anesthesia of the area of surgery and patients with a combination of spinal, local and conduction anesthesia of peripheral nerves of the lower extremity. It is proved that the most preferable option is the use of complex anesthetic management, including spinal, local and regional anesthesia. This type of anesthesia allows reliable control of pain syndrome, ensures stable parameters of vegetative homeostasis in the early postoperative period, improves the microcirculation and tissue perfusion.