TY - JOUR
T1 - Relative analgesic potencies of levobupivacaine and ropivacaine for caudal anesthesia in children
AU - Ingelmo, Pablo
AU - Ingelmo, Geoffc
AU - Astuto, Marinella
AU - Duffy, Chris
AU - Donath, Susan
AU - Disma, Nicola
AU - Rosano, Giuseppe
AU - Fumagalli, Roberto
AU - Gullo, Antonio
PY - 2009/3
Y1 - 2009/3
N2 - BACKGROUND: Comparing relative potency of new local anesthetics, such as levobupivacaine and ropivacaine, by the minimum local analgesic concentration model has not been described for caudal anesthesia. Therefore, we performed a prospective, randomized, double-blind study to determine the minimum local analgesic concentrations of a caudal single shot of ropivacaine and levobupivacaine in children and to describe the upper dose-response curve. METHODS: We performed a two-stage prospective, randomized, double-blind study comparing the dose-response curves of caudal ropivacaine and levobupivacaine in children. In phase 1, 80 boys were randomized to receive either ropivacaine or levobupivacaine. In the second phase a further 32 patients were randomly allocated to receive caudal anesthesia with doses designed to delineate the upper doseresponse range (the 50% effective dose [ED 50]-ED 95 range). RESULTS: There were no significant differences in ED 50 values for caudal ropivacaine and levobupivacaine. The ED50 for levobupivacaine estimated from the Dixon Massey method was 0.069% (95% CI 0.056%-0.082%) and for ropivacaine was 0.075% (95% CI 0.058%-0.092%). Estimated by isotonic regression the ED 50 and ED95 respectively of levobupivacaine were 0.068 (0.04-0.09) and 0.20% (95% CI 0.16%-0.24%). For ropivacaine ED 50 and ED 95 were 0.066 (0.033- 0.098) and 0.225% (95% CI 0.21%-0.24%). CONCLUSIONS: In children receiving one minimum alveolar anesthetic concentration of sevoflurane, there were no significant differences in the ED 50 for caudal levobupivacaine and ropivacaine. The potency ratio at ED 50 was 0.92 and 0.89 at ED 95, indicating that caudal levobupivacaine and ropivacaine have a similar potency.
AB - BACKGROUND: Comparing relative potency of new local anesthetics, such as levobupivacaine and ropivacaine, by the minimum local analgesic concentration model has not been described for caudal anesthesia. Therefore, we performed a prospective, randomized, double-blind study to determine the minimum local analgesic concentrations of a caudal single shot of ropivacaine and levobupivacaine in children and to describe the upper dose-response curve. METHODS: We performed a two-stage prospective, randomized, double-blind study comparing the dose-response curves of caudal ropivacaine and levobupivacaine in children. In phase 1, 80 boys were randomized to receive either ropivacaine or levobupivacaine. In the second phase a further 32 patients were randomly allocated to receive caudal anesthesia with doses designed to delineate the upper doseresponse range (the 50% effective dose [ED 50]-ED 95 range). RESULTS: There were no significant differences in ED 50 values for caudal ropivacaine and levobupivacaine. The ED50 for levobupivacaine estimated from the Dixon Massey method was 0.069% (95% CI 0.056%-0.082%) and for ropivacaine was 0.075% (95% CI 0.058%-0.092%). Estimated by isotonic regression the ED 50 and ED95 respectively of levobupivacaine were 0.068 (0.04-0.09) and 0.20% (95% CI 0.16%-0.24%). For ropivacaine ED 50 and ED 95 were 0.066 (0.033- 0.098) and 0.225% (95% CI 0.21%-0.24%). CONCLUSIONS: In children receiving one minimum alveolar anesthetic concentration of sevoflurane, there were no significant differences in the ED 50 for caudal levobupivacaine and ropivacaine. The potency ratio at ED 50 was 0.92 and 0.89 at ED 95, indicating that caudal levobupivacaine and ropivacaine have a similar potency.
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U2 - 10.1213/ane.0b013e3181935aa5
DO - 10.1213/ane.0b013e3181935aa5
M3 - Article
C2 - 19224787
AN - SCOPUS:61949118519
VL - 108
SP - 805
EP - 813
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 3
ER -