A retrospective comparison of ropivacaine and 2‐chloroprocaine continuous thoracic epidural analgesia for management of postthoracotomy pain in infants

Abstract

The use of 2-chloroprocaine for continuous epidural infusion in infants following thoracotomy was not inferior to ropivacaine and there was weak evidence for a reduction in opioid consumption in the first 24 h postoperatively. However, the 2-chloroprocaine group was more likely to receive ketorolac.

Continuous chloroprocaine paravertebral infusions for postoperative analgesia in infants and very young children

“…In a retrospective comparison study of ropivacaine and 2‐chloroprocaine for thoracic epidural analgesia in infants, Muhly compared epidural infusions of 2‐chloroprocaine to ropivacaine and showed infusion rates of 0.45 mL/kg/hr and 0.27 mg/kg/hr, respectively, with less opioid requirement in the 2‐chloroprocaine group 3 . Our mean infusion rate of 1.5% 2‐chloroprocaine was 0.7 mL/kg/hr and comparable to Bardain's PVNB catheter rates of 0.5‐0.8 mL/kg/hr and comparable to epidural infusions of 1.5% 2‐chloroprocaine 2‐4 . Systemic toxicity following 2‐chloroprocaine boluses in infants has been reported as self‐limited with no sequelae 6…”

“…Infants having regional anesthesia (RA) have increased risk for local anesthetic systemic toxicity and, following epidural bupivacaine infusions, can have high plasma bupivacaine concentrations 1 . Limited evidence supports the effective use of 2‐chloroprocaine in infant epidural infusions, 2,3 but reports of peripheral nerve blocks with 2‐chloroprocaine are sparse 4 …”

Regional anesthesia in neonates and infants outside the immediate perioperative period: A systematic review of studies with efficacy and safety considerations

“…Many of these scales have conflicting evidence with regard to their accuracy and have incomplete psychometric testing 9 . Among all the studies in this review, six different pain scales were used (CRIES, 53,60,65 OPS, 44 PAT, 45 FLACC, 48,55,56 PIPP, 55 and EDIN 59 ), with only two of them (CRIES and FLACC) used in more than one study. Altogether, there were no possible objective recommendations with regard to pain mitigation based on observable pain behaviors.…”

The Procaine-Base-Infusion: a Review after twenty Years of Use

“…shot of 25 till 50 mg Procaine to reach a systemic action. The pure Procaine infusion was firstly described by SEIFEN et al [37,38] and was mostly used as a continuous treatment in cases of acute pancreatitis [39][40][41] and for epidural anesthesia in infants, children and risk patients, which underlines the low toxicity of the substance [42][43][44][45][46][47][48][49]. O´DONNELL et al reported about the use of procaine infusion to block the cardiac nerves [50].…”