Comparison of ropivacaine 0.1% and 0.2% with bupivacaine 0.2% for single-shot caudal anaesthesia in children.
We compared analgesic efficacy and degree of motor block induced by ropivacaine 0.1% (R 0.1) and 0.2% (R 0.2) vs. bupivacaine 0.2% (B 0. 2) after caudal anaesthesia in children. Total and free plasma concentrations were measured after caudal injection. Duration of caudal analgesia (median/range) was significantly shorter in group R 0.1 (1.7 h/0.2-6 h) than in group R 0.2 (4.5 h/1.7-6 h) or group B 0. 2 (4 h/1-6 h) (P<0.05). Motor block in the first 2 h postoperatively was significantly less for both ropivacaine groups compared with bupivacaine (P<0.05). Peak plasma concentrations after ropivacaine 0.2% were higher and protein binding lower than after bupivacaine 0.2% (P<0.05). We conclude that caudal analgesia with ropivacaine 0.1% is less effective and of shorter duration than that of ropivacaine 0.2%, whereas ropivacaine 0.2% provides pain relief similar to bupivacaine 0.2%. Motor block in the early postoperative period is less with ropivacaine than with bupivacaine.
Luz
G
G
Department of Anaesthesia, University Hospital, 6020 Innsbruck, Austria.
Innerhofer
P
P
Häussler
B
B
Oswald
E
E
Salner
E
E
Sparr
H
H
D000577:Amides / Q000097:blood / Q000493:pharmacokinetics; D000763:Anesthesia, Caudal; D000779:Anesthetics, Local / Q000097:blood / Q000493:pharmacokinetics; D001798:Blood Proteins / Q000378:metabolism; D002045:Bupivacaine / Q000097:blood / Q000493:pharmacokinetics; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative; D009407:Nerve Block; D011229:Preanesthetic Medication; D011485:Protein Binding; D000077212:Ropivacaine
D000577:Amides; D000779:Anesthetics, Local; D001798:Blood Proteins; D000077212:Ropivacaine; D002045:Bupivacaine