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PEDIATRIC ANESTHESIA

Levobupivacaine for Pediatric Spinal Anesthesia

Hannu Kokki, MD, PhD^*, Paula Ylönen, BM^*, Marja Heikkinen, MD, and Matti Reinikainen, MD^*

Departments of *Anesthesiology and Intensive Care and Surgery, Kuopio University Hospital, Kuopio, Finland

Address correspondence and reprint requests to Hannu Kokki, MD, PhD, Department of Anesthesiology and Intensive Care, Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland. Address e-mail to hannu.kokki{at}kuh.fi

In this clinical trial we evaluated the clinical effects of levobupivacaine in spinal anesthesia in children. An open, noncomparative study was performed on 40 children, aged 1–14 yr, undergoing elective lower abdominal or lower limb surgery. A plain solution of S(-)-bupivacaine 5 mg/mL at a mean dose of 0.3 mg/kg body weight (range, 0.2–0.5 mg/kg body weight) was administered via the L3-4 or L4-5 interspace with the patient in the lateral decubitus position. After injection, the patients were placed supine. The spread and duration of sensory analgesia and the degree of motor block were recorded. Satisfactory surgical anesthesia was achieved in 39 of the 40 children. One child received supplemental anesthesia. The mean highest level of sensory block was T4 (range, T2 to L1), and the mean time to the regression of sensory block to T10 was 90 min (range, 43–185 min). A complete motor block was achieved in 36 children. These results are similar to those obtained with racemic bupivacaine in subarachnoid anesthesia in children.

IMPLICATIONS: This noncomparative, descriptive study showed that levobupivacaine, the S(-)-enantiomer of bupivacaine, has equivalent clinical efficacy in spinal anesthesia in children to that of racemic bupivacaine.

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