Ropivacaine in paediatric surgery: preliminary results

Abstract

In a double blind study 40 patients, aged 1-9 years, undergoing elective minor surgery were examined and randomly divided in two groups (20 children each). After light general anaesthesia Group 1 received caudal injection of bupivacaine 0.25% 2 mg.kg-1 while Group 2 received 0.2% ropivacaine 2 mg.kg-1. No differences were observed in demographic data, HR, BP and duration of surgery; the onset time of anaesthesia was 12 min and 9 min in Group 1 and 2 respectively. Ten patients in Group 1 received paracetamol in the first 24 h after surgery while only two children in Group 2 needed analgesic; even the duration of analgesia in the patients requiring paracetamol was superior in group 2 (520 min vs 253 min). No motor block was apparent at awakening in either group and no side effect was noticed. In conclusion ropivacaine seems to be an effective and safe drug in paediatric regional anaesthesia.

Comparative Study of Caudal Ropivacaine and Ropivacaine - Clonidine Combination in Paediatric Urogenital Surgeries for Post - Operative Analgesia

“…2 Some studies showed that use of ropivacaine in caudal block causes a quicker onset and longer duration of action than bupivacaine. 5 J of Evolution of Med and Dent Sci/ eISSN-2278-4802, pISSN-2278-4748/ Vol. 4/ Issue 60/ July 27, 2015…”

Evidence-based clinical update: Which local anesthetic drug for pediatric caudal block provides optimal efficacy with the fewest side effects?

“…Seventeen such RCTs were reviewed in detail using a structured methodology. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Two review articles were also identified. 18,19 The reference lists for all of these 19 publications were reviewed to identify any further RCTs that may have been missed with the initial search strategy; no such study was found.…”

“…One study 1 showed that levobupivacaine had a slower onset time compared with bupivacaine or ropivacaine; however, the difference was not clinically important. Another study 13 showed that bupivacaine had a slower onset time compared with ropivacaine, but again, the difference was not clinically important.…”

“…A third study comparing bupivacaine with ropivacaine showed a longer duration with ropivacaine, evidenced by the need for, and time of, first analgesia. 13 Unsurprisingly, a fourth study showed that 0.5% ropivacaine had a longer duration than 0.25% ropivacaine or bupivacaine. 17 In essence, only two studies showed a difference in duration when ''nearly'' equipotent doses of drug were used; one showed a longer duration with bupivacaine, 2 and one showed a longer duration with ropivacaine.…”

“…17 In essence, only two studies showed a difference in duration when ''nearly'' equipotent doses of drug were used; one showed a longer duration with bupivacaine, 2 and one showed a longer duration with ropivacaine. 13 …”