Ropivacaine for pediatric use

Abstract

As regional anesthesia and perioperative pain management become more integral parts of our anesthetic practice, the development of safer local anesthetics for our children is imperative. The release of ropivacaine, a new long-acting, aminoamide local anesthetic, for general use represents a step forward in efforts to achieve these goals. Bupivacaine, the agent of choice for longer acting regional anesthetic blocks, has been found to have life-threatening cardiac and neurotoxic side effects. Evidence has begun to accumulate that indicates a better safety profile for ropivacaine. Ropivacaine, a pure S-enantiomer unlike the racemate bupivacaine, produces a less dense motor block and a sensor block that is similar or better than bupivacaine. Initial studies in children have investigated the pharmacokinetics and pharmacodynamics of ropivacaine administered via the caudal and epidural routes. When combined with adjuncts, such as ketamine or clonidine, ropivacaine has been found to produce excellent, long-lasting anesthesia and analgesia. This report reviews the recent experience with ropivacaine in children. Copyright © 2001 by W.B. Saunders Company