Ropivacaine 0.2% pharm following caudal block in children

ABSTRACT

Ropivacaine is a long -acting amide local anasetheic that is available as a pure S-enantiomer.Several clinical studies have shown that ropivacaine is a suitable drug for epidural anaesthesia [1]. There has little published on the use of caudally administered ropivacaine in children. The aim of this study was to evaluate the pharmacokinetics of ropivacaine after caudal block in children, comparing infants [children aged between I and 5 years]. Thirty male children as a grade 1 and scheduled for subumblical surgery were enrolled in this prospective study after informed parent consent. The children were grouped according to age [15 [infant] aged less than 1 year and 15 [toddlers] aged 1-5 years. After induction of general anaesthesia .caudal epidural injection using ropivacaine 0.2% 1 ml/kg was performed .Plasma concentrations of ropivacaine in the first 2 hours after injection were determined by reversed -phase high-pressure liquid chromatography. Caudal blockade with ropivacaine 2mg/ml resulted in mean [ +/- SD] peak plasma concentrations of 0.69 micro g/ml [ +/- 0.29] in infants and 0.46 micro g/ml [ +/- 0.23] in toddlers [p<0.01].Maximum plasma concentrations occurred after a median range period of 60 [15-90] minutes and 53 [30-120] in infants and toddlers respectively. No clinical signs of local anaesthetic toxicity were observed. The results of the present study suggest that, caudal blockade using ropivacaine 0.2% 1mI/kg, from a pharmacokinetic point of view, can be considered a safe technique in children i.e.in infants as well as in toddlers