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British Journal of Anaesthesia, Vol 83, Issue 4 673-674, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia

CASE REPORTS

Ropivacaine and bupivacaine for long-term epidural infusion in a small child

B. Gustorff, P. Lierz, P. Felleiter, T. H. Knocke, K. Hoerauf and H. G. Kress
Department of Anaesthesiology and General Intensive Care (B) and Department of Radiotherapy and Radiobiology, University of Vienna, Austria

Ropivacaine is assumed to be less toxic than bupivacaine but there are no reports concerning its long-term use in paediatric anaesthesia. We report the use of ropivacaine for long-term epidural anaesthesia in a 21-month-old girl. In two consecutive periods of 3 days each, 0.5% bupivacaine and 0.5% or 0.75% ropivacaine were administered to facilitate painful vaginal brachytherapy. The mean dose of bupivacaine increased from 1.05 to 1.32 mg kg-1 h-1 and that of ropivacaine increased from 1.40 to 3.86 mg kg-1 h-1. No toxic side effects were observed. We conclude that both epidural ropivacaine and bupivacaine were effective and safe during long-term epidural anaesthesia in this particular case. However, the doses were potentially toxic and should therefore be used with extreme caution.
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