title: Ropivacaine and bupivacaine for long-term epidural infusion in a small child.
abstract: 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.
authors.affiliation: Department of Anaesthesiology and General Intensive Care (B), University of Vienna, Austria. burkhard.gustorff@univie.ac.at
authors.forename: B
authors.initials: B
authors.lastname: Gustorff
authors.forename: P
authors.initials: P
authors.lastname: Lierz
authors.forename: P
authors.initials: P
authors.lastname: Felleiter
authors.forename: T H
authors.initials: TH
authors.lastname: Knocke
authors.forename: K
authors.initials: K
authors.lastname: Hoerauf
authors.forename: H G
authors.initials: HG
authors.lastname: Kress
mesh_terms: 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
chemical_list: D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077212:Ropivacaine; D002045:Bupivacaine