Document Detail

Spread of ropivacaine by a weight-based formula in a pediatric caudal block: a fluoroscopic examination.
MedLine Citation:
PMID:  20236099     Owner:  NLM     Status:  MEDLINE    
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 C(0.5)), for inguinal hernia repair 1 ml/kg (group C(1.0)), and for orchiopexy 1.25 ml/kg (group C(1.25)). 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 C(0.5), T12 [L1-T8] in group C(1.0), and T10 [L2-T7] in group C(1.25). Analysis by age distribution (infants: <12 months; toddlers: 12-36 months; and children: >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.
B-N Koo; J-Y Hong; H K Kil
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Publication Detail:
Type:  Journal Article     Date:  2010-03-10
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  562-5     Citation Subset:  IM    
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea.
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MeSH Terms
Amides / administration & dosage,  pharmacokinetics*
Anesthesia, Caudal / methods*
Anesthetics, Local / administration & dosage,  pharmacokinetics*
Body Weight
Child, Preschool
Contrast Media / administration & dosage,  pharmacokinetics
Dose-Response Relationship, Drug
Drug Compounding
Hernia, Inguinal / surgery
Lumbosacral Region / radiography
Nerve Block / methods
Spinal Cord / metabolism,  radiography*
Reg. No./Substance:
0/Amides; 0/Anesthetics, Local; 0/Contrast Media; 84057-95-4/ropivacaine

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