Relative Analgesic Potencies of Levobupivacaine and Ropivacaine for Caudal Anesthesia in Children

Ingelmo, Pablo; Frawley, Geoff; Astuto, Marinella; Duffy, Chris; Donath, Susan; Disma, Nicola; Rosano, Giuseppe M.C.; Gullo, A

doi:10.1213/ane.0b013e3181935aa5

Cited by 31 publications

(27 citation statements)

References 28 publications

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“…4 -6,8 The type of block may also have an influence on the potency ratio between these 2 drugs, because clinical equipotency has mainly been demonstrated in patients undergoing epidural analgesia. [13][14][15] The clinically relevant finding of this study is the nearly 50% longer analgesia provided by the injection of 20 mL levobupivacaine 0.5% around the posterior sciatic nerve compared with the same dose of ropivacaine. Therefore, levobupivacaine should be considered when postoperative analgesia is required for foot and ankle surgery.…”

Section: Discussionmentioning

confidence: 72%

Levobupivacaine 0.5% Provides Longer Analgesia After Sciatic Nerve Block Using the Labat Approach Than the Same Dose of Ropivacaine in Foot and Ankle Surgery

Fournier

Faust

Chassot

et al. 2010

Anesthesia &Amp; Analgesia

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Section: Discussionmentioning

confidence: 72%

Levobupivacaine 0.5% Provides Longer Analgesia After Sciatic Nerve Block Using the Labat Approach Than the Same Dose of Ropivacaine in Foot and Ankle Surgery

Fournier

Faust

Chassot

et al. 2010

Anesthesia &Amp; Analgesia

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“…17 Chandran et al compared 0.75% ropivacaine and 0.5% bupivacaine epidurally, and concluded that there were no significant differences in the block parameters but ropivacaine was associated with relatively longer duration of postoperative analgesia. 18 In 2004, Cline et al 19 compared 0.5% levobupivacaine and 0.5% ropivacaine in combination with 1:200,000 epinephrine for axillary brachial plexus block, and found that sensory analgesia was significantly longer with levobupivacaine than with ropivacaine, but ropivacaine patients showed a faster recovery of motor function.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Isobaric 0.5% Levobupivacaine Combined With 50 MCG Fentanyl Versus Isobaric 0.5% Ropivacaine Combined With 50 MCG Fentanyl in Lumbar Epidural Anaesthesia for Elective Infraumbilical Surgery

Dasgupta¹,

Samui²,

Swaika³

et al. 2016

jemds

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BACKGROUNDThis prospective, randomised, double-blinded study compared the onset and duration of epidural anaesthesia produced by levobupivacaine and ropivacaine. MATERIALS AND METHODSSeventy adult patients of ASA physical status I and II were divided into two groups of 35 each by pre-decided randomisation schedule, Group R to receive epidural isobaric ropivacaine 0.5% 15 mL combined with 50 mcg fentanyl and Group L to receive epidural isobaric levobupivacaine 0.5% 15 mL combined with 50 mcg fentanyl. A blinded observer evaluated onset and regression of motor and sensory block, and requirement of rescue analgesia. RESULTSOnset of sensory block was comparable in both groups. Onset of motor block was longer in group R (18.4+/-1.77 min. in Group R vs. 15.69 +/-0.76 min. in group L). In both groups, maximum sensory level reached was T5. Duration of motor block was found to be significantly shorter in group R as compared to group L (175.9+/-8.53 min. in Group L vs. 150.9+/-7.12 min. in Group R). Duration of analgesia was comparable in both groups (231.0+/-9.2195 min. in Group L and 233.54 +/-8.4064 min. in Group R). Haemodynamic variables were comparable in both groups. CONCLUSIONSLevobupivacaine 0.5% produced a sensory block of similar onset, quality, and duration as ropivacaine 0.5% but a longer duration of motor block. KEYWORDS BACKGROUNDAs perioperative physicians, anaesthesiologists are responsible for proper pain management during the perioperative period, creation of innovative approaches to acute pain management, and extending their care for acute postoperative pain services as well. A variety of neuraxial and peripheral regional analgesic techniques are being used for effective perioperative analgesia. In general, the analgesia provided by epidural and peripheral techniques is superior to that with only systemic opioids, 1 with reduced morbidity and mortality. 2,3 Regional anaesthesia offers several advantages over general anaesthesia -provides excellent intraoperative analgesia, blunts stress response to surgery, decreases intraoperative

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“…Furthermore a recent study showed that there were no significant differences in the ed 50 for caudal levobupivacaine and ropivacaine; the potency ratio at ed 50 was 0.92 and 0.89 at ed 95 , indicating that caudal levobupivacaine and ropivacaine have a similar potency. 30 As for the volume of administration of the local anaesthetic solution, we always used the same volume, in accordance with the literature, 16,17,26,30 for two reasons. Firstly, all surgery procedures falling within the t12 -t10 methamers appear well covered by an injection of 1ml/kg of the local anaesthetic solution, if given through the caudal technique.…”

Section: Discussionmentioning

confidence: 99%

Cardiocirculatory intraoperative assessment during single-shot caudal anaesthesia in children: comparison between levobupivacaine and ropivacaine

et al. 2012

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Background: Caudal block with levobupivacaine or ropivacaine is the most commonly used regional anaesthesia in children. Methods: The aim of study was to compare the cardiocirculatory profile induced in two matched groups of young patients, submitted to caudal anaesthesia with levobupivacaine or ropivacaine for an elective subumbilical surgery. Sixty children were enrolled: thirty received levopubivacaine 0.25% and thirty ropivacaine 0.2%. Intraoperative heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) were monitored at following times: Ta0 (after anaesthesia induction), Ta1 (after caudal anaesthesia), Ta2 (five minutes later), Ta3 (ten minutes later), Ts1 (at surgical incision), Ts2, Ts3, Ts4, Ts5 (every 10 minutes during surgery), Taw (at the awakening). Results: In both groups the cardiocirculatory trend remained within normal ranges at all times considered, demonstrating the safety of the method with both drugs. Both groups showed a similar trend at the different monitoring times: low decrease in HR, SBP and DBP after caudal block, slight increase in parameters after skin incision, slight decrease during surgery, increase at awakening. Regarding SBP and DBP, the levobupivacaine group children generally showed higher levels compared to the ropivacaine group, especially for DBP. Conclusions: Paediatric caudal anaesthesia is an effective method with an very infrequent complication rate. Possible hypotheses for differing haemodynamic behaviour could include a stronger vasoconstriction reflex of innervated areas during caudal anaesthesia with levobupivacaine and a lower levobupivacaine induced block of the sympathetic fibers, related to different pharmacokinetic profile of low concentrations of the local anaesthetics used in paediatric epidural space. RiassuntoIntroduzione: l'anestesia caudale con levobupivacaina o ropivacaina è la più comunemente usata in età pediatrica. Metodi: Scopo dello studio è paragonare il profilo cardiocircolatorio in due gruppi di pazienti sottoposti ad anestesia caudale con levobupivacaina o ropivacaina durante interventi a livello sottombelicale di elezione. Sessanta bambini sono stati studiati: trenta hanno utilizzato levobupivacaina (0.25%), gli altri trenta ropivacaina (0.2%). durante l'intervento sono stati monitorizzati frequenza cardiaca (FC), pressione arteriosa sistolica (PAS) e 133 diastolica (PAd) nei seguenti tempi: ta0 (al termine dell'induzione), ta1 (dopo anestesia caudale), ta2, ta3 (5, 10 minuti dopo la caudale), ts1 (al momento dell'incisione), ts2, ts3, ts4, ts5 (ogni 10 minuti durante l'intervento chirurgico), taw (al risveglio). Risultati: in entrambi i gruppi l'andamento cardiocircolatorio è stato normale, dimostrando una tecnica sicura con entrambi i farmaci. il comportamento emodinamico è stato simile per i due farmaci nei diversi tempi studiati: lieve riduzione di FC, PAS e PAd dopo la caudale, modesto aumento dei parametri all'incisione della cute con successiva riduzione durante l'intervento e incremento al risveglio. i b...

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Relative Analgesic Potencies of Levobupivacaine and Ropivacaine for Caudal Anesthesia in Children

Cited by 31 publications

References 28 publications

Levobupivacaine 0.5% Provides Longer Analgesia After Sciatic Nerve Block Using the Labat Approach Than the Same Dose of Ropivacaine in Foot and Ankle Surgery

Levobupivacaine 0.5% Provides Longer Analgesia After Sciatic Nerve Block Using the Labat Approach Than the Same Dose of Ropivacaine in Foot and Ankle Surgery

A Comparative Study of Isobaric 0.5% Levobupivacaine Combined With 50 MCG Fentanyl Versus Isobaric 0.5% Ropivacaine Combined With 50 MCG Fentanyl in Lumbar Epidural Anaesthesia for Elective Infraumbilical Surgery

Cardiocirculatory intraoperative assessment during single-shot caudal anaesthesia in children: comparison between levobupivacaine and ropivacaine

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