ABSTRACT
[This corrects the article DOI: 10.1016/j.bjae.2019.06.003.].
ABSTRACT
Pediatric regional anesthesia (PRA) is widely practiced today; reassuring data from international literature show its safety and efficacy. However, for many years, PRA was considered an extravagant and ineffective technique by many detractors.
ABSTRACT
Postoperative pain treatment is the challenge of the new century; we know that even starting from the 24(th) week of gestational age, the fetus can feel pain and that memory of uncontrolled pain can change the pain threshold in children. We have now new drugs and new tools for an optimal pain control also in children and this review is an update on the new therapies and devices which can help us in the daily clinical practice.
Subject(s)
Analgesics/therapeutic use , Pain, Postoperative/drug therapy , Analgesics, Non-Narcotic/therapeutic use , Analgesics, Opioid/therapeutic use , Anesthetics, Local/therapeutic use , Child , Child, Preschool , Clinical Trials as Topic , Humans , Infant , Infant, Newborn , Nerve BlockABSTRACT
BACKGROUND: Previous published data comparing ropivacaine 0.2% with levobupivacaine 0.25% have suggested that ropivacaine might be associated with less early postoperative motor blockade compared with levobupivacaine. The aim of the present study was to further investigate this issue comparing equal concentrations (0.2%) of ropivacaine and levobupivacaine in children undergoing minor subumbilical surgery. METHODS: Following induction of a standardized anesthetic, patients (1-7 years) were randomized in a double-blind manner to receive a caudal block with either ropivacaine 0.2% (group R, n=30) or levobupivacaine 0.2% (group L, n=30), total volume 1 ml.kg-1. Motor blockade (modified Bromage scale; primary end-point) and analgesia [Children and Infants Postoperative Pain Scale (CHIPPS) score] were assessed at predetermined time points during the first 24-postoperative hours. RESULTS: Motor blockade was only registered during the first postoperative hour with no significant differences between the groups (group R n=5, group L n=8). Postoperative CHIPPS scores were almost identical in both groups with only seven and six patients requiring supplemental analgesia (CHIPPS score>or=4) in the R and L groups, respectively. CONCLUSIONS: A 0.2% concentrations of ropivacaine or levobupivacaine are clinically very similar with regard to postoperative analgesia and unwanted postoperative motor blockade in children undergoing minor subumbilical surgery.
