Use of ropivacain and lidocaine for axillary plexus blockade

Objective: The use of certain peripheral nerve blocks in paediatric patients is gaining increasing popularity, although distinctive characteristics of the juvenile anatomy, psychological barriers, time constraints on block placement, and risks of neurotoxic and cardio toxic side effects are still me...

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Bibliographic Details
Published in:African journal of paediatric surgery 2010-05, Vol.7 (2), p.101-104
Main Authors: Felfernig, Michael, Marhofer, Peter, Weintraud, Marion, Huber, Gudrun, Duma, Andreas, Nosa, Aihie, Kapral, Stephan
Format: Article
Language:English
Subjects:
Anesthesia
Brachial plexus
Children
Diseases
Drug safety
Drug therapy
Health aspects
Hospitals
infants
Lidocaine
local anaesthetics
Peripheral nerve diseases
plexus anaesthesia
Toxicity
trauma
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Summary:Objective: The use of certain peripheral nerve blocks in paediatric patients is gaining increasing popularity, although distinctive characteristics of the juvenile anatomy, psychological barriers, time constraints on block placement, and risks of neurotoxic and cardio toxic side effects are still mentioned. However, newer agents like Ropivacaine and Levobupivacaine seem to offer excellent alternatives to Bupivacaine and Lidocaine, especially for use in paediatric patients. Materials and Methods: We evaluated Ropivacaine 0.5% and Lidocaine 1.0% using axillary plexus blockade as a single-shot technique in 50 children in the age group of 2 to 10 years and undergoing short upper limb surgery. The primary objectives were to compare onset time, duration and quality of block and the incidence of breakthrough pain. Results: Onset time was longer in the Ropivacaine group (15.4 minutes) than in the Lidocaine group (8.2 minutes). The duration of the effect was greater in patients in the Ropivacaine group (337 minutes) than in the Lidocaine group (137 minutes). Duration appeared to vary with patient's age but this effect was not statistically significant. Conclusion: Axillary plexus anaesthesia provides satisfactory perioperative pain relief in infants undergoing short-trauma surgery. Apart from its safety, these results underline that Ropivacaine 0.5% can be recommended for axillary brachial plexus block in children.
ISSN:0189-6725
0974-5998
DOI:10.4103/0189-6725.62860