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Stable plasma concentrations of unbound ropivacaine during postoperative epidural infusion for 24-72 hours in

C B Berde1, M Yaster, O Meretoja

  • 1Children's Hospital, Boston, MA, USA.

European Journal of Anaesthesiology
|January 22, 2008
PubMed

Insights

Continuous epidural ropivacaine infusion in children aged 1-9 years demonstrated stable unbound plasma concentrations over 24-72 hours, with no age-related differences and no observed toxicity.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacokinetics
  • Pain Management

Background:

  • Continuous epidural ropivacaine infusion is used for pediatric analgesia.
  • Limited data exists on long-term pharmacokinetic profiles in children.

Purpose of the Study:

  • To evaluate the pharmacokinetics and safety of a 24-72 hour continuous epidural ropivacaine infusion in children aged 1-9 years.
  • To assess plasma concentrations and potential toxicity.

Main Methods:

  • An open, multi-center study involving 29 pediatric patients (1-9 years) undergoing major surgery.
  • Lumbar epidural catheters were placed, followed by a ropivacaine bolus and a continuous infusion (0.4 mg kg(-1) h(-1)) for 24-72 hours.

Main Results:

  • Total ropivacaine plasma concentrations increased over time, while unbound concentrations remained stable and below adult toxicity thresholds.
  • No age-dependency was observed in apparent unbound clearance.
  • No systemic toxicity or cardiovascular effects were noted; additional analgesics were administered.

Conclusions:

  • Continuous epidural ropivacaine infusion at 0.4 mg kg(-1) h(-1) for 24-72 hours is safe and effective in children aged 1-9 years.
  • Stable unbound plasma concentrations suggest predictable pharmacokinetics without age-related variations.
Abstract

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