Ropivacaine and bupivacaine for long-term epidural infusion in a small child.
Ropivacaine is assumed to be less toxic than bupivacaine but there are no reports concerning its long-term use in paediatric anaesthesia. We report the use of ropivacaine for long-term epidural anaesthesia in a 21-month-old girl. In two consecutive periods of 3 days each, 0.5% bupivacaine and 0.5% or 0.75% ropivacaine were administered to facilitate painful vaginal brachytherapy. The mean dose of bupivacaine increased from 1.05 to 1.32 mg kg-1 h-1 and that of ropivacaine increased from 1.40 to 3.86 mg kg-1 h-1. No toxic side effects were observed. We conclude that both epidural ropivacaine and bupivacaine were effective and safe during long-term epidural anaesthesia in this particular case. However, the doses were potentially toxic and should therefore be used with extreme caution.
Gustorff
B
B
Department of Anaesthesiology and General Intensive Care (B), University of Vienna, Austria. burkhard.gustorff@univie.ac.at
Lierz
P
P
Felleiter
P
P
Knocke
T H
TH
Hoerauf
K
K
Kress
H G
HG
D000577:Amides / Q000008:administration & dosage*; D000767:Anesthesia, Epidural / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001918:Brachytherapy; D002045:Bupivacaine / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D012208:Rhabdomyosarcoma / Q000532:radiotherapy; D000077212:Ropivacaine; D014625:Vaginal Neoplasms / Q000532:radiotherapy
D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077212:Ropivacaine; D002045:Bupivacaine