罗哌卡因在小儿髂腹股沟/髂腹下神经阻滞后的药代动力学及镇痛效果

Pharmacokinetics and analgesic effect of ropivacaine following ilioinguinal/iliohypogastric nerve block in children.

作者信息

Dalens B, Ecoffey C, Joly A, Giaufré E, Gustafsson U, Huledal G, Larsson L E

机构信息

Department of Anaesthesia and Intensive Care, Hotel Dieu Hospital, Clermont Ferrand, France.

出版信息

Paediatr Anaesth. 2001 Jul;11(4):415-20. doi: 10.1046/j.1460-9592.2001.00691.x.

DOI:10.1046/j.1460-9592.2001.00691.x

PMID:11442857

Abstract

BACKGROUND

The aim was to investigate the efficacy, tolerance and pharmacokinetics of ropivavcaine when administered for ilioinguinal/iliohypogastric block in children.

METHODS

We examined the pharmacokinetics and analgesic efficacy after ilioinguinal/iliohypogastric nerve block with 3 mg.kg-1 ropivacaine 5 mg.ml-1 in 22 children, aged 1-12 years, who were scheduled for inguinal surgery. Sixteen of 22 patients had a postoperative pain score < 4 (Objective Pain Scale). Nine children were given supplementary analgesics during the first six postoperative hours.

RESULTS

The peak plasma concentration of total ropivacaine was 1.50 +/- 0.93 mg.l-1 (mean +/- SD) (range 0.64-4.77 mg.l-1) 15-64 min after the injection. The peak plasma concentration of free ropivacaine was 0.05 +/- 0.03 mg.l-1 (0.02-0.14 mg.l-1), which is well below the threshold for toxicity in adults. The terminal half-life was 2.0 +/- 0.7 h. No safety concerns or symptoms suggestive of systemic toxicity were observed.

CONCLUSION

A dose of 3 mg.kg-1 of ropivacaine given as a single ilioinguinal/iliohypogastric nerve block in 1-12-year-old children provides satisfactory postoperative pain relief, and is well tolerated.

摘要

背景

目的是研究罗哌卡因用于儿童髂腹股沟/髂腹下神经阻滞时的疗效、耐受性和药代动力学。

方法

我们对22例计划行腹股沟手术、年龄在1至12岁的儿童，给予3mg·kg-1的5mg·ml-1罗哌卡因行髂腹股沟/髂腹下神经阻滞，检测其药代动力学和镇痛效果。22例患者中有16例术后疼痛评分<4（客观疼痛量表）。9名儿童在术后前6小时给予了补充镇痛药。

结果

注射后15至64分钟，罗哌卡因总血浆峰浓度为1.50±0.93mg·l-1（平均值±标准差）（范围0.64 - 4.77mg·l-1）。游离罗哌卡因的血浆峰浓度为0.05±0.03mg·l-1（0.02 - 0.14mg·l-1），远低于成人中毒阈值。终末半衰期为2.0±0.7小时。未观察到安全问题或提示全身毒性的症状。