Epidural sufentanil with ropivacaine for postoperative pain relief in infants: Postinfusion pharmacokinetics

Fentanyl with ropivacaine infusion for postoperative pain relief in infants and children. Kinetics of epidural fentanyl

“…As shown in our previous study (7,8), plasma concentration of sufentanil is highest 3-6 h after discontinuation of the infusion with ropivacaine; therefore, the potential risk of respiratory depression may be still present in this period of time. Very little is known about the pharmacokinetics of fentanyl administered as a continuous epidural infusion in children (2,9), and there are no data describing postinfusion kinetics.…”

“…Thirteen infants and toddlers (median age 14 [range 3-36] months, weight 11 [5][6][7][8][9][10][11][12][13][14][15][16][17] kg, Group I) and 11 children (68 [45-131] months, 21 kg, Group II) completed the study. Five infants and one older child dropped out either because of catheter dislodgement, or because of the insufficient number of blood samples drawn in the postinfusion period (<3).…”

“…Objectives: The aim of the study was to evaluate pharmacokinetics of fentanyl administered as continuous epidural infusion with 0.2% ropivacaine for postoperative pain relief in infants and toddlers, and older children undergoing major abdominal and urological procedures. Methods: Thirteen infants and toddlers (median age 14 [range 3-36] months, 11 [5][6][7][8][9][10][11][12][13][14][15][16][17] kg, Group I) and 11 children (68 [45-131] months, 21 kg, Group II) participated in the study. Epidural catheter was placed under general anesthesia in the L1-L2, L2-L3, or L3-L4 epidural space and threaded up to 4 cm into the epidural space.…”

Pharmacokinetics of sufentanil administered with 0.2% ropivacaine as a continuous epidural infusion for postoperative pain relief in infants

“…In the postoperative period, the dose of sufentanil was lowered to 0.037 μg·kg −1 ·h −1 . Based on the results of the pilot study , which showed a significant increase in the sufentanil concentration in plasma after the termination of the epidural infusion, the infusion was stopped on the second postoperative day at midnight, and the vital signs were monitored in the PACU for the next 8 h, before the transfer to the surgical ward.…”