Levobupivacaine for Pediatric Spinal Anesthesia

Kokki, Hannu; Ylönen, Paula; Heikkinen, Markku; Reinikainen, Matti

doi:10.1213/01.ane.0000093309.75358.30

Cited by 42 publications

(41 citation statements)

References 10 publications

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“…The present study demonstrates that ropivacaine is an effective local anesthetic for spinal applications in children because the success rate of the block, 92%, was the same as has been reported with racemic bupivacaine (11) and levobupivacaine (13). In addition, there was only one failed spinal block with ropivacaine, similar to that with bupivacaine (11,13).…”

Section: Discussionsupporting

confidence: 84%

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Isobaric Ropivacaine 5 mg/mL for Spinal Anesthesia in Children

Kokki

Ylönen

Laisalmi

et al. 2005

Anesthesia & Analgesia

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In this clinical trial, we evaluated the clinical effects of ropivacaine for spinal anesthesia in children. An open, prospective study was performed on 93 children, aged 1-17 yr, undergoing elective lower abdominal or lower limb surgery. A plain solution of ropivacaine 5 mg/mL at a dose of 0.5 mg/kg body weight (up to 20 mg) was administered via the L3-4 or L4-5 interspace with the patient in the lateral decubitus position. After injection, the patients were placed supine. The spread and duration of sensory analgesia and the degree of motor block were recorded. Satisfactory surgical anesthesia was achieved in 92 of the 93 children. Three children received general anesthesia; in one child spinal anesthesia failed, and in two cases surgery outlasted the duration of the sensory block. Four children received supplemental analgesia for skin incision. The mean highest level of sensory block was T6 (range, T2 to T12), and the mean time to the regression of sensory block to T10 was 96 min (range, 34-210 min). One child developed transient bradycardia and one hypotension. After discharge four children developed mild transient radiating neurologic symptoms and one epidural blood patch was performed for persistent position-dependent headache. We conclude that the block performance of intrathecal isobaric ropivacaine in children (>1 yr) is similar to that obtained in adults but the safety of the larger dose used in children warrants further studies.

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Section: Discussionsupporting

confidence: 84%

“…In addition, there was only one failed spinal block with ropivacaine, similar to that with bupivacaine (11,13). However, whether ropivacaine should replace bupivacaine in intrathecal use is open for discussion.…”

Section: Discussionmentioning

confidence: 99%

Isobaric Ropivacaine 5 mg/mL for Spinal Anesthesia in Children

Kokki

Ylönen

Laisalmi

et al. 2005

Anesthesia & Analgesia

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“…[22][23][24] The clinical outcomes of levobupivacaine in children who underwent spinal anaesthesia were similar to those achieved with the same dose of bupivacaine. 25 A randomized, double-blind study of intrathecally administered 0.5% isobaric levobupivacaine or 0.5% hyperbaric bupivacaine in 70 patients scheduled to undergo elective transurethral endoscopic surgery found similar results between the two groups for the following variables: duration of sensory block, duration of two segment regression, time of onset and expiration of motor block, side effects, and pain scores at the beginning of the operation. 26 The authors suggested that 2.5 ml of 0.5% isobaric levobupivacaine and 0.5% hyperbaric bupivacaine provided the same clinical outcomes for spinal anaesthesia.…”

Section: Discussionmentioning

confidence: 96%

Intrathecal bupivacaine or levobupivacaine: Which should be used for elderly patients?

et al. 2014

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Objectives: To compare two intrathecal anaesthetics, bupivacaine and levobupivacaine, for their effects on motor and sensory blockade and haemodynamics in patients aged !65 years undergoing transurethral resection of the prostate (TUR-P) or transurethral resection of the urinary bladder (TUR-M). Methods: Patients scheduled to undergo TUR-P or TUR-M were randomized to receive either 3 ml (15 mg) 0.5% isobaric levobupivacaine (group L) or 3 ml (15 mg) of 0.5% hyperbaric bupivacaine (group B) for spinal anaesthesia. The onset time, maximum level and time to reach the maximum level of sensory and motor blockade were recorded. Changes to haemodynamic parameters were also recorded. Results: The study randomized 100 patients: 57 to group L and 43 to group B. Levobupivacaine did not cause any significant changes in haemodynamic parameters, including systolic blood pressure, and showed a similar sensory block onset time compared with bupivacaine, but it had a significantly longer motor block onset time compared with bupivacaine. Conclusion: These current findings suggest that levobupivacaine can be used as a substitute for bupivacaine for spinal anaesthesia in elderly patients !65 years of age undergoing elective TUR-P or TUR-M operations.

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“…[25 ] and Kokki et al [23 ] recently used levobupivacaine for performing spinal anaesthesia in neonates and children respectively. Levobupivacaine has been indicated to be safer than racemic bupivacaine because of the lower potential for cardiovascular and central-nervous-system toxicity, while maintaining similar properties and clinical efficacy.…”

Section: Drugs and Dosagesmentioning

confidence: 99%