Local anesthetic dosing and toxicity of pediatric truncal catheters: a narrative review of published practice
Authors' conclusion
Bolus doses of bupivacaine and ropivacaine frequently comport with expert recommendations. Infusions in patients under 6 months used doses associated with toxicity and toxicity occurred at a rate consistent with single-shot blocks.
Study context
- Population
- Children (<18 years) with paravertebral or TAP catheter infusions intended for ≥24 hours46 papers
- Participants
- 945 children
- Comparison
- Ropivacaine vs bupivacaine paravertebral and TAP catheter infusions
- Outcome
- Bolus and infusion dosing
Main finding
As reported in the abstract
| Group | Value | Bolus n | Infusion dose, median (range 0.2-0.68), mg/kg/hour | Infusion n | Infusion dose, median (range 0.1-1.0), mg/kg/hour |
|---|---|---|---|---|---|
| Ropivacaine | median 2.5 (range 0.6–5.0) mg/kg | 466 | 0.5 | 521 | |
| Bupivacaine | median 1.25 (range 0.5–2.5) mg/kg | 294 | 423 | 0.33 |
Value
Ropivacainemedian 2.5 (range 0.6–5.0) mg/kg
Bupivacainemedian 1.25 (range 0.5–2.5) mg/kg
Bolus n
Ropivacaine466
Bupivacaine294
Infusion dose, median (range 0.2-0.68), mg/kg/hour
Ropivacaine0.5
Bupivacaine— not stated in the abstract
Infusion n
Ropivacaine521
Bupivacaine423
Infusion dose, median (range 0.1-1.0), mg/kg/hour
Ropivacaine— not stated in the abstract
Bupivacaine0.33
- Infusion dosing consistent with a ropivacaine:bupivacaine dose equivalence
- 1.5:1.0
Safety
Local anesthetic systemic toxicity and toxic blood levels
- Serum levels above the toxic threshold (pharmacokinetic studies), cases
- at least five
- A single case of toxicity reported
Original publication
Local anesthetic dosing and toxicity of pediatric truncal catheters: a narrative review of published practice. Reg Anesth Pain Med. Published 9 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →