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Analgesic Effect Comparison and Pharmacokinetic Study of Ropivacaine with Different Concentrations in Continuous Serratus Anterior Plane Block in Patients Undergoing Video-Assisted Thoracoscopic Surgery
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  • jieru chen,
  • jiaqi chen,
  • wei gao,
  • hai gu,
  • xiaoqing chai,
  • xianning wu,
  • Feng Xiao,
  • di wang
jieru chen

Corresponding Author:chenjieru@stu.ahmu.edu.cn

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jiaqi chen
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xiaoqing chai
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xianning wu
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Feng Xiao
Anhui Medical University
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Aims: The serratus anterior plane block (SAPB) has commonly been utilized as a regional anesthesia technique for pain management in various upper chest surgical procedures. The purpose of this study was to investigate the analgesic effect and pharmacokinetics of ropivacaine in continuous SAPB undergoing VATS. Methods: This prospective randomized study included patients scheduled for elective VATS. Patients first received a bolus of 20 ml of 0.2% (Group L) or 0.375% (Group H) ropivacaine that was administered beneath the serratus anterior muscle. The pump was connected to the catheter for continuous administration within 48 hours postoperatively, in which a background infusion at a rate of 7 ml·h−1 of low-dose at 0.2% (Group L) or high-dose at 0.375% (Group H) of ropivacaine was administered. The main results were to compare the analgesic effects and analyze the pharmacokinetics of different concentrations of ropivacaine. Results: Eighty-eight patients agreed to participate in the trial and were recruited. The VAS scores in Group H at 12, 24, and 48 hours postoperatively at rest and on coughing were significantly lower than those in Group L. The peak values of total ropivacaine plasma concentrations were observed at 48 hours (2.01 μg·mL−1 for Group L and 2.93 μg·mL−1 for Group H), which were far below the theoretical toxicity threshold. Postoperative rescue analgesia, complications, and other outcomes did not differ significantly. Conclusions: In VATS patients, the analgesic effect of 0.2% ropivacaine for continuous SAPB was not inferior to that of 0.375% ropivacaine, and the blood concentration of 0.2% ropivacaine was
31 Jul 2022Submitted to British Journal of Clinical Pharmacology
02 Aug 2022Submission Checks Completed
02 Aug 2022Assigned to Editor
15 Oct 2022Reviewer(s) Assigned
01 Jan 2023Review(s) Completed, Editorial Evaluation Pending
02 Jan 2023Editorial Decision: Revise Major
28 Jan 20231st Revision Received
03 Feb 2023Assigned to Editor
03 Feb 2023Submission Checks Completed
03 Feb 2023Review(s) Completed, Editorial Evaluation Pending
12 Feb 2023Reviewer(s) Assigned
23 Apr 2023Editorial Decision: Revise Major
25 May 20232nd Revision Received
26 May 2023Submission Checks Completed
26 May 2023Assigned to Editor
26 May 2023Review(s) Completed, Editorial Evaluation Pending