Ropivacaine vs bupivacaine in major surgery in infants

Purpose: To assess and compare the onset time and duration of neuroblockade obtained after ropivacaine or bupivacaine in infants undergoing major abdo minal surgery. We also evaluated the efficacy and safety of employing ropiv acaine instead of bupivacaine to provide operative anesthesia and postopera tive analgesia. Methods: In a prospective double blind study 28 infants, aged 1-12 months, undergoing elective major abdominal surgery, were randomly allocated to rec eive, after induction of general anesthesia, either 0.7 ml.kg(-1) bupivacai ne 0.25% (group B) or ropivacaine 0.2%, (group R) via lumbar epidural block , The onset time, total surgical time and duration of analgesia were record ed. Results: No differences were noted in demographic data, hemodynamic variabl es or duration of surgery. The onset time for sensory blockade was 13.1 min +/- 2.1 (group B) and 11.7 +/- 2.4 min (group R). The duration-of analgesi a was 491 +/- 291 (group R) and 456 min +/- 247 (group B). Eight patients i n group B and six in group R needed codeine and acetaminophen rescue on at least one occasion during the 24 hr study period. No major side effects wer e noted in either groups. Conclusions: In infants undergoing major abdominal surgery under combined e pidural/light general anesthesia, ropivacaine 0.2% produces sensory and mot or blockade similar in onset, duration of action and efficacy to that obtai ned from an equal volume, 0.7 ml.kg(-1), of bupivacaine 0.25%.