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Ropivacaine pharmacokinetics after caudal block in 1-8 year old children
P A Lönnqvist1, P Westrin, B A Larsson
1Department of Paediatric Anaesthesia and Intensive Care, KS/Astrid Lindgren's Children's Hospital, Stockholm, Sweden.
British Journal of Anaesthesia
|November 7, 2000
Summary
Ropivacaine caudal blocks in children aged 1-8 years for subumbilical surgery showed safe plasma concentrations. The drug was well tolerated, providing effective pain relief without motor block.
Area of Science:
- Pediatric Anesthesiology
- Pharmacokinetics
- Regional Anesthesia
Background:
- Ropivacaine is a local anesthetic used for postoperative pain management.
- Understanding its pharmacokinetics in pediatric patients is crucial for safe and effective use.
- Caudal block is a common regional anesthesia technique in children.
Purpose of the Study:
- To evaluate the pharmacokinetics of ropivacaine after caudal block in children undergoing subumbilical surgery.
- To assess the safety profile and efficacy of ropivacaine for pediatric postoperative pain relief.
Main Methods:
- An open, non-comparative, multicentre study involving 20 children aged 1-8 years.
- Ropivacaine (2 mg/ml, 1 ml/kg) was administered via caudal block.
- Venous blood samples were collected for up to 12-36 hours to measure plasma concentrations.
Main Results:
- Mean peak plasma concentration of ropivacaine was 0.47 (0.16) mg/L, achieved between 12-249 minutes.
- The highest individual peak plasma concentration of free ropivacaine was 0.04 mg/L.
- Clearance was 7.4 (1.9) ml/min/kg with a terminal half-life of 3.2 (0.8) hours.
Conclusions:
- Pediatric patients demonstrated a well-developed capacity to eliminate ropivacaine.
- Free plasma concentrations remained below toxic levels observed in adults.
- Ropivacaine provided satisfactory postoperative pain relief without significant motor block and was well tolerated.
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