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Skin Blood Flow after Intradermal Injection of Ropivacaine in Various Concentrations with and without Epinephrine Evaluated by Laser Doppler Flowmetry
  1. I. Cederholm, M.D.,
  2. H. Evers, D.D.S., PH.D. and
  3. J.B. LÖfstrÖm, M.D., PH.D.
  1. Presented at the annual congress of the European Society of Regional Anaesthesia, Bern, Switzerland, September 5-8, 1990.
  2. From the Department of Anaesthesiology, University Hospital, Linköping, Sweden, and the Department of Clinical Pharmacology, Astra Pain Control, Södertälje, Sweden.
  3. Supported by the Medical Faculty, Linköping University, Sweden, and Astra Pain Control, Södertälje, Sweden.
  1. Address correspondence to I. Cederholm, M.D., Department of Anaesthesiology, University Hospital, S-581 85 Linköping, Sweden.

Abstract

Background and Objectives. Skin blood flow changes after intradermal injection of ropivacaine in various concentrations with or without epinephrine were investigated using laser Doppler flowmetry.

Methods. Twenty-three non-smoking, healthy, young male volunteers participated. Four test sites were used on each forearm (volar surface) in a randomized, double-blind study. Recordings were made at 20, 40, 60, and 90 minutes after intradermal injection (0.1 ml, 30-gauge needle). Injections of saline and 1% lidocaine and an untreated area served as controls. In Series 1, various concentrations of ropivacaine (1%, 0.5%, 0.375%, 0.125%, and 0.063%) were injected.

Results. The data from this series showed a doseresponse relationship: 1% ropivacaine provoked an increase in skin blood flow similar to saline; 0.5% and weaker concentrations of ropivacaine showed a reduction in flow compared to saline, this being more pronounced with the weakest solutions (0.125% and 0.063%). In Series 2, injection of 1:200,000 (5 μg/ml) epinephrine alone and injections of ropivacaine in various concentrations (1%, 0.5%, and 0.25%) with addition of epinephrine were carried out. Injection of epinephrine alone showed a flow almost as low as at the untreated control sites. Ropivacaine epinephrine injections were followed by a lower skin blood flow compared to saline, but the flow was significantly larger compared to the effect of epinephrine itself at the 20-minute recording.

Conclusion. The combination of ropivacaine and adrenaline did not accentuate but instead diminished the vasoconstrictive effect of epinephrine.

  • Adrenaline
  • intradermal injection
  • laser Doppler flowmetry
  • lidocaine
  • local anesthetic agents
  • ropivacaine
  • skin blood flow.

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Footnotes

  • The authors thank Anna Torrång, B.S., for advice and contribution to the statistical evaluation; Jan Sjövall, Ph.D., associate professor and head of the Department of Clinical Pharmacology, Astra Pain Control for suggestions; Mats Bengtsson, M.D., Ph.D., associate professor and head of the Department of Anaesthesiology, University Hospital, Linköping, Sweden, for advice and criticism; and Ingemar Ideholm, Astra Reklam, for help with the graphic presentations.

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