Use of ropivacaine and lidocaine for axillary plexus blockade.
OBJECTIVE
The use of certain peripheral nerve blocks in paediatric patients is gaining increasing popularity, although distinctive characteristics of the juvenile anatomy, psychological barriers, time constraints on block placement, and risks of neurotoxic and cardio toxic side effects are still mentioned. However, newer agents like Ropivacaine and Levobupivacaine seem to offer excellent alternatives to Bupivacaine and Lidocaine, especially for use in paediatric patients.


METHODS
We evaluated Ropivacaine 0.5% and Lidocaine 1.0% using axillary plexus blockade as a single-shot technique in 50 children in the age group of 2 to 10 years and undergoing short upper limb surgery. The primary objectives were to compare onset time, duration and quality of block and the incidence of breakthrough pain.


RESULTS
Onset time was longer in the Ropivacaine group (15.4 minutes) than in the Lidocaine group (8.2 minutes). The duration of the effect was greater in patients in the Ropivacaine group (337 minutes) than in the Lidocaine group (137 minutes). Duration appeared to vary with patient's age but this effect was not statistically significant.


CONCLUSIONS
Axillary plexus anaesthesia provides satisfactory perioperative pain relief in infants undergoing short-trauma surgery. Apart from its safety, these results underline that Ropivacaine 0.5% can be recommended for axillary brachial plexus block in children.
Felfernig
Michael
M
Medical Department, SMI Clinic, Port Harcourt, Nigeria.
Marhofer
Peter
P
Weintraud
Marion
M
Huber
Gudrun
G
Duma
Andreas
A
Nosa
Aihie
A
Kapral
Stephan
S
D000577:Amides / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001365:Axilla / Q000294:innervation; D001917:Brachial Plexus / Q000187:drug effects* / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control; D000077212:Ropivacaine; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000601:surgery
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D008012:Lidocaine