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Spread of ropivacaine by a weight-based formula in a pediatric caudal block: a fluoroscopic examination
- Source :
- Acta Anaesthesiologica Scandinavica. 54:562-565
- Publication Year :
- 2010
- Publisher :
- Wiley, 2010.
-
Abstract
- Background: Caudal block is the most common regional technique to provide post-operative analgesia in pediatric infra-umbilical surgery. This study was designed to define how many spinal segments would be covered by the weight-based dosage of caudally administered 0.2% ropivacaine in children using the fluoroscopic method. Methods: After an approval from the institutional human research review board, in 83 ASA I boys undergoing day-case urological surgery, the distribution of ropivacaine mixed with a radioactive dye in relation to the volume injected caudally was studied. Three groups were studied: for perineal surgery 0.5 ml/kg (group C0.5), for inguinal hernia repair 1 ml/kg (group C1.0), and for orchiopexy 1.25 ml/kg (group C1.25). The dose of 0.2% ropivacaine containing radiopaque dye at a ratio of 1 : 4 was injected at a rate of 1 ml 3 s−1. Fluoroscopic examination was performed immediately to define the level of the drug spread within the extradural space. Results: The highest spinal levels [median with ranges] of spread were L2 [L4-T12] in group C0.5, T12 [L1-T8] in group C1.0, and T10 [L2-T7] in group C1.25. Analysis by age distribution (infants: 36 months) revealed a larger spread in younger patients. Conclusions: Based on the fluoroscopic findings, the weight-based doses for caudally administered 0.2% bupivacaine suggested by Armitage are also useful for ropivacaine to block the spinal level required for the different types of surgeries studied.
- Subjects :
- Male
medicine.medical_specialty
medicine.drug_class
Drug Compounding
medicine.medical_treatment
Block (permutation group theory)
Contrast Media
Hernia, Inguinal
medicine
Humans
Fluoroscopy
Ropivacaine
Orchiopexy
Hernia
Anesthetics, Local
Bupivacaine
Dose-Response Relationship, Drug
medicine.diagnostic_test
business.industry
Local anesthetic
Body Weight
Lumbosacral Region
Infant
Nerve Block
General Medicine
medicine.disease
Amides
Surgery
Inguinal hernia
Anesthesiology and Pain Medicine
Spinal Cord
Child, Preschool
Anesthesia
business
Anesthesia, Caudal
medicine.drug
Subjects
Details
- ISSN :
- 13996576 and 00015172
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Acta Anaesthesiologica Scandinavica
- Accession number :
- edsair.doi.dedup.....7a24ca1c50f37a8524d24df88fd7ecf0