The safety of a mixture of bupivacaine and lidocaine in children after urologic inguinal and scrotal surgery

Abstract

PurposeLocal anesthetic agents such as bupivacaine and lidocaine are commonly used after surgery for pain control. The aim of this prospective study was to evaluate the safety of a mixture of bupivacaine and lidocaine in children who underwent urologic inguinal and scrotal surgery.Materials and MethodsFifty-five patients who underwent pediatric urologic outpatient surgeries, were prospectively enrolled in this study. The patients were divided into three groups according to age (group I: under 2 years, group II: between 3−4 years, and group III: 5 years and above). Patients were further sub-divided into unilateral and bilateral groups. All patients were injected with a mixture of 0.5% bupivacaine and 2% lidocaine (2:1 volume ratio) at the surgical site, just before the surgery ended. Hemodynamic and electrocardiographic parameters were measured before local anesthesia, 30 minutes after administration of local anesthesia, and 60 minutes after administration.ResultsThe patients' mean age was 40.5±39.9 months. All patients had normal hemodynamic and electrocardiographic parameters before local anesthesia, after 30 minutes, and after 60 minutes. Also, results of all intervals were within normal values, when analyzed by age and laterality. No mixture related adverse events (nausea, vomiting, pruritus, sedation, respiratory depression) or those related to electrocardiographic parameters (arrhythmias and asystole) were reported in any patients.ConclusionsA mixture of bupivacaine and lidocaine can be safely used in children undergoing urologic inguinal and scrotal surgery. An appropriate dose has no clinically significant hemodynamic or cardiac changes and adverse effects.

Clinical Evaluation for Effectiveness and Safety of Lidocaine and Bupivacaine Combination Epidural Infusion for the Management of Post-Total Hip Replacement Pain

“…Mild adverse effects could be explained by the competence behavior between lidocaine and bupivacaine on binding to sodium channel receptor sites, in which lidocaine has higher affinity and ability to associate and dissociate than bupivacaine. Thus, lower incidence of sympathetic block expected indeed [18].…”

Let's Take Advantage of Mixtures of Bupivacaine or Ropivacaine in Urologic Inguinal and Scrotal Surgery

“…Lee et al [ 1 ] recently published a very interesting article, which is one of the few reports about the safety of a mixture of bupivacaine in children who underwent urologic inguinal and scrotal surgery. In their study, patients were injected with a mixture of 0.5% bupivacaine and 2% lidocaine (2:1 volume ratio) at the surgical site, just before surgery ended [ 1 ].…”

“…Lee et al [ 1 ] recently published a very interesting article, which is one of the few reports about the safety of a mixture of bupivacaine in children who underwent urologic inguinal and scrotal surgery. In their study, patients were injected with a mixture of 0.5% bupivacaine and 2% lidocaine (2:1 volume ratio) at the surgical site, just before surgery ended [ 1 ]. Hemodynamic and electrocardiographic parameters were measured before local anesthesia, 30 minutes after the administration of local anesthesia, and 60 minutes after administration [ 1 ].…”

“…In their study, patients were injected with a mixture of 0.5% bupivacaine and 2% lidocaine (2:1 volume ratio) at the surgical site, just before surgery ended [ 1 ]. Hemodynamic and electrocardiographic parameters were measured before local anesthesia, 30 minutes after the administration of local anesthesia, and 60 minutes after administration [ 1 ]. The results of their study indicate that no mixturerelated adverse events (nausea, vomiting, pruritus, sedation, or respiratory depression) or adverse events related to electrocardiographic parameters (arrhythmias or asystole) were reported in any patients [ 1 ].…”

“…Hemodynamic and electrocardiographic parameters were measured before local anesthesia, 30 minutes after the administration of local anesthesia, and 60 minutes after administration [ 1 ]. The results of their study indicate that no mixturerelated adverse events (nausea, vomiting, pruritus, sedation, or respiratory depression) or adverse events related to electrocardiographic parameters (arrhythmias or asystole) were reported in any patients [ 1 ]. The observation that even children did not experience side effects suggests that this mixture will be even safer in adults.…”