Related Experiment Videos
Levobupivacaine spinal anesthesia in neonates: a dose range finding study
Geoff P Frawley1, Tanya Farrell, Sarah Smith
1Department of Paediatric Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, Australia. geoff.frawley@rch.org.au
Paediatric Anaesthesia
|September 24, 2004
Summary
Levobupivacaine is effective for spinal anesthesia in neonates, with a recommended dose of 1 mg/kg. This study determined the minimum local analgesic dose (MLAD) for neonates undergoing surgery.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Neonatal surgery presents unique anesthetic challenges.
- Assessing anesthetic efficacy and safety in ex-premature infants is crucial.
- Levobupivacaine's role in neonatal spinal anesthesia requires further elucidation.
Purpose of the Study:
- To evaluate the clinical effectiveness of levobupivacaine for spinal anesthesia in ex-premature infants.
- To determine the minimum local analgesic dose (MLAD) for spinal anesthesia in neonates.
Main Methods:
- Fifty neonates (<55 weeks postconceptional age) undergoing lower abdominal surgery were included.
- Levobupivacaine dosage was determined using an up-down sequential allocation method.
- Doses ranged from 0.5 to 1.25 mg/kg with 0.25 mg/kg intervals.
Main Results:
- Levobupivacaine demonstrated no significant adverse effects.
- Success rates varied by dose, with 100% at 1.25 mg/kg and 83% at 1 mg/kg.
- The motor block minimum local analgesic dose (MLAD) was 0.48 mg/kg; ED50 was 0.52 mg/kg and ED95 was 1.14 mg/kg.
Conclusions:
- Levobupivacaine is an effective agent for neonatal spinal anesthesia at a recommended dose of 1 mg/kg.
- Its potency for motor blockade appears equivalent to racemic bupivacaine in this population.
- Levobupivacaine provides adequate anesthesia duration for lower abdominal surgeries in neonates.