Ropivacaine and bupivacaine for long-term epidural infusion in a small child

Area of Science:

• Anesthesiology
• Pediatric Anesthesia
• Pain Management

Background:

• Limited data exists on the long-term use of ropivacaine in pediatric anesthesia.
• Ropivacaine is generally considered less toxic than bupivacaine.

Observation:

• A 21-month-old girl received long-term epidural anesthesia for vaginal brachytherapy over two 3-day periods.
• 0.5% bupivacaine and 0.5% or 0.75% ropivacaine were administered.
• Mean doses of bupivacaine ranged from 1.05 to 1.32 mg kg-1 h-1.
• Mean doses of ropivacaine ranged from 1.40 to 3.86 mg kg-1 h-1.

Findings:

• No toxic side effects were observed during the administration of either epidural ropivacaine or bupivacaine.
• Both agents were effective in providing anesthesia for the procedure.
• The administered doses of ropivacaine, particularly at higher concentrations, were potentially toxic.

Implications:

• Epidural ropivacaine can be considered for long-term pediatric anesthesia in specific cases.
• Extreme caution is advised due to potentially toxic doses.
• Further research is needed to establish safe and effective dosing guidelines for long-term pediatric epidural ropivacaine use.