Total systemic ropivacaine concentrations following aerosolized intraperitoneal delivery using the AeroSurge.
OBJECTIVE
To evaluate intraperitoneal ropivacaine delivery with the AeroSurge device in the clinical setting and to evaluate the total systemic ropivacaine levels achieved following delivery of 50 mg of aerosolized ropivacaine.


METHODS
Preliminary, prospective, nonrandomized study.


METHODS
Operating room of a university hospital.


METHODS
5 consecutive ASA physical status 1 and 2 patients undergoing elective laparoscopic Nissen fundoplication or cholecystectomy.


METHODS
Five mL of 1% ropivacaine was delivered through the 10 mm port using the AeroSurge device at peritoneal insufflation.


METHODS
Venous blood samples were collected and total ropivacaine concentration was determined using liquid chromatography-mass spectrometry.


RESULTS
The AeroSurge device delivered ropivacaine, visible as mist within the peritoneal cavity. Peak concentration (Cmax) was attained between 10 and 30 minutes following the end of aerosolized ropivacaine delivery. At no stage did any level approach toxic levels.


CONCLUSIONS
This preliminary study confirms that aerosolized intraperitoneal local anesthetic is feasible, with ropivacaine concentrations remaining within safe levels.
Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland. Electronic address: ailbhemcdermott@gmail.com.
Ailbhe M
AM
McDermott
Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland.
Kah Hoong
KH
Chang
Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland.
Kelly
K
Mieske
Department of Anesthesia, Galway Clinic, Doughiska, Galway, Ireland.
Abdelaly
A
Abeidi
Department of Anesthesia, Galway Clinic, Doughiska, Galway, Ireland; Department of Anesthesia, University Hospital Galway, Galway, Ireland.
Brian H
BH
Harte
Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland.
Michael J
MJ
Kerin
Discipline of Surgery, School of Medicine, National University of Ireland, Galway, Ireland.
Oliver J
OJ
McAnena
D000328:Adult; D000336:Aerosols; D000368:Aged; D000577:Amides / Q000008:administration & dosage* / Q000097:blood; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000097:blood; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D002853:Chromatography, Liquid / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D018662:Fundoplication / Q000379:methods; D006801:Humans; D007274:Injections, Intraperitoneal / Q000295:instrumentation / Q000379:methods; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D000077212:Ropivacaine
D000336:Aerosols; D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine
Anesthetics, local; Cholecystectomy, laparoscopic; Drug administration routes; Laparoscopy