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Levobupivacaine for pediatric spinal anesthesia.
Hannu Kokki1, Paula Ylönen, Marja Heikkinen
1Departments of *Anesthesiology and Intensive Care and †Surgery, Kuopio University Hospital, Kuopio, Finland.
Anesthesia and Analgesia
|December 25, 2003
Summary
Levobupivacaine provides effective spinal anesthesia in children, similar to racemic bupivacaine. This study confirms its clinical efficacy for pediatric surgical procedures.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Levobupivacaine is the S(-)-enantiomer of bupivacaine, developed to reduce cardiotoxicity.
- Spinal anesthesia is frequently used in pediatric surgery for lower abdominal and limb procedures.
Purpose of the Study:
- To evaluate the clinical effects and efficacy of levobupivacaine in pediatric spinal anesthesia.
- To compare the efficacy of levobupivacaine with racemic bupivacaine in children.
Main Methods:
- An open, noncomparative study involving 40 children (aged 1-14 years) undergoing elective surgery.
- Administration of plain levobupivacaine (5 mg/mL) at 0.3 mg/kg via the L3-4 or L4-5 interspace.
- Assessment of sensory analgesia spread and duration, and motor block degree.
Main Results:
- Satisfactory surgical anesthesia was achieved in 39 of 40 children.
- Mean highest sensory block level was T4, with regression to T10 at a mean of 90 minutes.
- Complete motor block occurred in 36 children, comparable to racemic bupivacaine.
Conclusions:
- Levobupivacaine demonstrates equivalent clinical efficacy to racemic bupivacaine for spinal anesthesia in children.
- The S(-)-enantiomer of bupivacaine is a safe and effective option for pediatric anesthesia.
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