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Ropivacaine in infants and children

机译：罗哌卡因在婴幼儿中的应用

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Ropivacaine is considered less toxic than bupivacaine. In addition, at the low concentrations used for providing postoperative analgesia, ropivacaine seems to produce less motor blockade than bupivacaine. These two properties are of particular interest in paediatric practice.In paediatric practice regional anaesthesia is usually performed under general anaesthesia, and postoperative analgesia was until recently the major concern for most practitioners. The question now is: what is the right concentration to provide adequate intraoperative anaesthesia when ropivacaine is used in combination with volatile anaesthetic agents? The low concentration of ropivacaine used for postoperative analgesia seems to provide adequate intraoperative anaesthesia when general anaesthesia with a 0.5 minimum concentration of volatile anaesthetic is used in combination. However, potential toxicity is still the subject of debate because ropivacaine clearance is low in infancy and early childhood. Ropivacaine has a longer absorption process than bupivacaine, which leads to a lower maximum peak concentration with ropivacaine than with bupivacaine either after central or peripheral blocks, thus increasing the safety of the drug. The addition of adjuvant drugs also permits lower concentrations of ropivacaine, while providing excellent analgesia. The addition of adrenaline at very low concentrations has recently been found to increase the quality of epidural analgesia.Ropivacaine is now the reference drug for regional anaesthesia in paediatric patients, mainly because it is considered less toxic than bupivacaine and provides excellent postoperative analgesia even when used at low concentrations.
机译：罗哌卡因被认为比布比卡因毒性小。另外，在用于术后镇痛的低浓度下，罗哌卡因似乎比布比卡因产生更少的运动阻滞。这两个属性在儿科实践中特别令人感兴趣。在儿科实践中，区域麻醉通常在全身麻醉下进行，而术后镇痛直到最近仍是大多数医生关注的主要问题。现在的问题是：罗哌卡因与挥发性麻醉剂联合使用时，什么浓度才能提供足够的术中麻醉？当全身麻醉与挥发性麻醉药的最低浓度为0.5的组合使用时，用于术后镇痛的低浓度罗哌卡因似乎可提供足够的术中麻醉。但是，潜在的毒性仍然是争论的话题，因为在婴儿期和儿童早期罗哌卡因清除率很低。罗哌卡因的吸收过程比布比卡因更长，这导致在中央或周边阻滞后，罗哌卡因的最大峰值浓度低于布比卡因，从而增加了药物的安全性。辅助药物的添加还可以降低罗哌卡因的浓度，同时提供出色的镇痛作用。最近发现以非常低的浓度添加肾上腺素可以提高硬膜外镇痛的质量。罗哌卡因现在是小儿患者局部麻醉的参考药物，主要是因为它被认为比布比卡因毒性小，即使使用时也能提供出色的术后镇痛作用。低浓度。

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