Related Experiment Video

Updated: Jul 19, 2026

Use of a Piglet Model for the Study of Anesthetic-induced Developmental Neurotoxicity (AIDN): A Translational Neuroscience Approach
06:38

Use of a Piglet Model for the Study of Anesthetic-induced Developmental Neurotoxicity (AIDN): A Translational Neuroscience Approach

Published on: June 11, 2017

New insights into paediatric regional anaesthesia: new drugs

G Ivani1, P De Negri

  • 1Department of Anaesthesiology and Intensive Care, Regina Margherita Children's Hospital, Turin, Italy. gioivani@ipsnet.it

Current Opinion in Anaesthesiology
|October 5, 2006
PubMed

Insights

Newer local anesthetics like ropivacaine and levobupivacaine offer improved safety for pediatric regional anesthesia. Combining them with clonidine or ketamine can extend pain relief duration in children.

Area of Science:

  • Anesthesiology
  • Pediatric Pain Management
  • Regional Anesthesia

Background:

  • Pediatric regional anesthesia is a well-established component of perioperative pain management.
  • Ensuring safety and efficacy of epidural drug administration in children is crucial.
  • Traditional local anesthetics have limitations in safety and efficacy.

Purpose of the Study:

  • To review recent data on ropivacaine and levobupivacaine for pediatric regional anesthesia.
  • To discuss the use of adjuvants like clonidine and ketamine to prolong analgesia.
  • To provide an overview of current practices in pediatric pain control.

Main Methods:

  • Literature review of recent studies on pediatric regional anesthesia.
  • Analysis of safety and efficacy data for ropivacaine and levobupivacaine.
  • Evaluation of adjuvant use (clonidine, ketamine) in pediatric anesthesia.

Main Results:

  • Ropivacaine and levobupivacaine demonstrate a favorable safety profile compared to older agents.
  • These agents provide effective pain control in pediatric patients.
  • Clonidine and ketamine show promise as effective adjuvants for prolonged analgesia.

Conclusions:

  • Ropivacaine and levobupivacaine represent advancements in pediatric regional anesthesia safety and efficacy.
  • Adjuvants like clonidine and ketamine are valuable tools for optimizing pain management duration.
  • This review highlights the evolving landscape of pediatric perioperative pain control.

More Related Videos

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention08:49

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention

Published on: October 16, 2013

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
Local Anesthetics: Chemistry and Structure-Activity Relationship01:30

Local Anesthetics: Chemistry and Structure-Activity Relationship

Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...