A retrospective comparison of ropivacaine and 2‐chloroprocaine continuous thoracic epidural analgesia for management of postthoracotomy pain in infants

Continuous thoracic epidural analgesia is useful in the management of infants following thoracotomy. Concerns about drug accumulation and toxicity limit the amount of amide local anesthetics that can be delivered. Continuous epidural infusions of the ester local anesthetic chloroprocaine result in little drug accumulation allowing for higher infusion rates. We retrospectively compared patients managed with 1.5% 2‐ chloroprocaine or 0.1% ropivacaine epidural infusions to determine if the increased infusion rate resulted in similar or improved analgesia.

[1]  J. Tobias,et al.  Chloroprocaine for epidural anesthesia in infants and children , 2017, Paediatric anaesthesia.

[2]  A. Dotta,et al.  Comparison of regional vs systemic analgesia for post‐thoracotomy care in infants , 2014, Paediatric anaesthesia.

[3]  P. Vicini,et al.  Ketorolac tromethamine: stereo‐specific pharmacokinetics and single‐dose use in postoperative infants aged 2–6 months , 2011, Paediatric anaesthesia.

[4]  U. Christians,et al.  Pharmacokinetics of Single-Dose Intravenous Ketorolac in Infants Aged 2–11 Months , 2011, Anesthesia and analgesia.

[5]  P. Harris,et al.  Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support , 2009, J. Biomed. Informatics.

[6]  A. Zuppa,et al.  Population Pharmacokinetics of Ketorolac in Neonates and Young Infants , 2009, American journal of therapeutics.

[7]  A. Ganesh,et al.  Efficacy of Addition of Fentanyl to Epidural Bupivacaine on Postoperative Analgesia after Thoracotomy for Lung Resection in Infants , 2008, Anesthesiology.

[8]  D. Salinger,et al.  Postoperative Ketorolac Tromethamine Use in Infants Aged 6–18 Months: The Effect on Morphine Usage, Safety Assessment, and Stereo-Specific Pharmacokinetics , 2007, Anesthesia and analgesia.

[9]  A. Bösenberg,et al.  Pharmacokinetics and efficacy of ropivacaine for continuous epidural infusion in neonates and infants , 2005, Paediatric anaesthesia.

[10]  C. Romagnoli,et al.  Use of intravenous ketorolac in the neonate and premature babies , 2004, Paediatric anaesthesia.

[11]  R. Kauffman,et al.  A randomized comparison of ketorolac tromethamine and morphine for postoperative analgesia in critically ill children. , 1999, Critical care medicine.

[12]  A. Bösenberg Epidural analgesia for major neonatal surgery , 1998, Paediatric anaesthesia.

[13]  J. Brock,et al.  Continuous caudal anaesthesia with chloroprocaine as an adjunct to general anaesthesia in neonates , 1997, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[14]  J. Tobias,et al.  Chloroprocaine for epidural anesthesia in infants and children. , 1995, AANA journal.

[15]  S. Krechel,et al.  CRIES: a new neonatal postoperative pain measurement score. Initial testing of validity and reliability , 1995, Paediatric anaesthesia.

[16]  C. Berde,et al.  Continuous caudal anesthesia for inguinal hernia repair in former preterm infants. , 1993, Journal of clinical anesthesia.

[17]  B. R. Kuhnert,et al.  The Half‐Life of 2‐Chloroprocaine , 1986, Anesthesia and analgesia.

[18]  J. Downs,et al.  Plasma cholinesterase activity in newborns and infants , 1971, Canadian Anaesthetists' Society journal.

[19]  H. Lehmann,et al.  Pseudocholinesterase in Early Infancy , 1957, Proceedings of the Royal Society of Medicine.

[20]  M. Finster,et al.  Metabolism and Measurement of Chloroprocaine, an Ester-Type Local Anesthetic , 1979 .