Trial reportAnesthesiology2016
Effect of Intralipid® on the Dose of Ropivacaine or Levobupivacaine Tolerated by Volunteers: A Clinical and Pharmacokinetic Study.
Trial report in Anesthesiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01602250 (Prevention of Systemic Toxicity Induced by Levobupivacaine and Ropivacaine by Intralipid®), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prevention of Systemic Toxicity Induced by Levobupivacaine and Ropivacaine by Intralipid®
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- Systematic Review and Meta-Analysis of Lipid Emulsion for Non-Local Anesthetic Poisoning.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Pooled it
- The impact of local anesthetic systemic toxicity advisories on reporting to the National Poison Data System (NPDS).Regional anesthesia and pain medicine · 2026Article
- Local anesthetic dosing for fascial plane blocks to avoid systemic toxicity: a narrative review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Review
- The preventive efficacy of lipid emulsion on the occurrence of local anesthetic systemic toxicity in patients receiving local infiltration analgesia for total joint arthroplasty.Journal of orthopaedic surgery and research · 2024Article
- Intravenous Lipid Emulsion Therapy in Drug Overdose and Poisoning: An Updated Review.The Eurasian journal of medicine · 2024Article
- Mechanisms underlying lipid emulsion resuscitation for drug toxicity: a narrative review.Korean journal of anesthesiology · 2023Review
- Lipid emulsion for xenobiotic overdose: PRO.British journal of clinical pharmacology · 2023Article
- Lipid Emulsion to Treat Acute Poisonings: Mechanisms of Action, Indications, and Controversies.Pharmaceutics · 2023Review
- Sodium bicarbonate reverts electrophysiologic cardiotoxicity of ropivacaine faster than lipid emulsions in a porcine model.Basic & clinical pharmacology & toxicology · 2023Article
- Predicting the efficacy of opioid sequestration by intravenous lipid emulsion using biologically relevant in vitro models of drug distribution.Scientific reports · 2022Article
- Continuous Ropivacaine Peroneal Nerve Infiltration for Fibula Free Flap in Cervicofacial Cancer Surgery: A Randomized Controlled Study.Journal of clinical medicine · 2022Article
- Cardiac Arrest after Small Doses Ropivacaine: Local Anesthetic Systemic Toxicity in the Course of Continuous Femoral Nerve Blockade.International journal of environmental research and public health · 2022Article
- Local Anesthesia in Interventional Radiology.Seminars in interventional radiology · 2022Review
- Cardio Protective Effects of Lipid Emulsion against Ropivacaine-Induced Local Anesthetic Systemic Toxicity-An Experimental Study.Journal of clinical medicine · 2022Article
- Predicting Inter-individual Variability During Lipid Resuscitation of Bupivacaine Cardiotoxicity in Rats: A Virtual Population Modeling Study.Drugs in R&D · 2021Article
- Mechanisms and Efficacy of Intravenous Lipid Emulsion Treatment for Systemic Toxicity From Local Anesthetics.Frontiers in medicine · 2021Review
- Update on Local Anesthetic Toxicity, Prevention and Treatment During Regional Anesthesia in Infants and Children.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Review
- Intravenous lipid emulsion modifies synaptic transmission in hippocampal CA1 pyramidal neurons after bupivacaine-induced central nervous system toxicity.Journal of neurochemistry · 2020Article
- The Efficacy and Safety of Paravertebral Block Combined with Parecoxib During Video-Assisted Thoracic Surgery: A Randomized Controlled Trial.Journal of pain research · 2020Article
- Local anesthetic systemic toxicity: proposed mechanisms for lipid resuscitation and methods of prevention.Journal of anesthesia · 2019Article
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRapid intravenous administration of lipid emulsion has become the standard treatment of severe local anesthetic systemic toxicity. This experiment in volunteers aimed at determining the effect of Intralipid® administration on the time to neurologic symptoms.
methodsRopivacaine or levobupivacaine was infused intravenously in 16 volunteers (8 mg/min up to 120 mg) with 120 ml Intralipid® 20% (Fresenius, Paris France) or placebo infused at T + 2 min). Each subject received all four treatments in a crossover manner. The infusion was stopped after the intended dose had been administered or on occurrence of incipient neurologic signs of toxicity. The primary outcome was time-to-event. In addition, blood ropivacaine and levobupivacaine concentrations were measured.
resultsThe dose infused was not different whether volunteers received placebo (81.7 ± 22.3 vs. 80.8 ± 31.7 mg, ropivacaine vs. levobupivacaine) or Intralipid® (75.7 ± 29.1 vs. 69.4 ± 26.2 mg, ropivacaine vs. levobupivacaine), P = 0.755, Intralipid® versus placebo groups. Plasma concentrations were best modeled with an additional volume of distribution associated with Intralipid®. Simulations suggested that decreased peak concentrations would be seen if Intralipid® was given during a period of increasing concentrations after extravascular administration.
conclusionsAt modestly toxic doses of ropivacaine or levobupivacaine, we were unable to find any effect of the infusion of Intralipid® on the time to early signs of neurologic toxicity in volunteers. Peak concentration was decreased by 26 to 30% in the subjects receiving Intralipid®. Simulations showed that Intralipid® might prevent the rapid increase of local anesthetic concentration after extravascular administration.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.