Chloroprocaine for epidural anesthesia in infants and children
Summary Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bow...
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| Veröffentlicht in: | Pediatric anesthesia 2017-06, Vol.27 (6), p.581-590 |
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| container_title | Pediatric anesthesia |
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| creator | Veneziano, Giorgio Tobias, Joseph D. Thomas, Mark |
| description | Summary
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long‐term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics. Chloroprocaine, an ester local anesthetic agent, which is rapidly metabolized in plasma at all ages, is an attractive alternative for this special population, particularly in the presence of superimposed liver impairment or when higher infusion rates are needed for surgical incisions stretching many dermatomes. The current manuscript reviews the literature pertaining to the use of 2‐chloroprocaine for regional anesthesia in infants and children. Dosing regimens are presented and the applications of 2‐chloroprocaine in this population are discussed. |
| doi_str_mv | 10.1111/pan.13134 |
| format | Article |
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Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long‐term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics. Chloroprocaine, an ester local anesthetic agent, which is rapidly metabolized in plasma at all ages, is an attractive alternative for this special population, particularly in the presence of superimposed liver impairment or when higher infusion rates are needed for surgical incisions stretching many dermatomes. The current manuscript reviews the literature pertaining to the use of 2‐chloroprocaine for regional anesthesia in infants and children. Dosing regimens are presented and the applications of 2‐chloroprocaine in this population are discussed.</description><identifier>ISSN: 1155-5645</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1111/pan.13134</identifier><identifier>PMID: 28321983</identifier><language>eng</language><publisher>France: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; analgesia ; Analgesia, Epidural ; Anesthesia ; Anesthesia, Epidural ; anesthesia, regional ; Anesthetics, Local ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Infusion Pumps ; Local anesthesia ; pediatrics ; Procaine - analogs & derivatives</subject><ispartof>Pediatric anesthesia, 2017-06, Vol.27 (6), p.581-590</ispartof><rights>2017 John Wiley & Sons Ltd</rights><rights>2017 John Wiley & Sons Ltd.</rights><rights>Copyright © 2017 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3534-f2f347d69b9d422db2720f34935f356f990d89a361a4585fbc75a39f8d6ab61d3</citedby><cites>FETCH-LOGICAL-c3534-f2f347d69b9d422db2720f34935f356f990d89a361a4585fbc75a39f8d6ab61d3</cites><orcidid>0000-0003-4244-9845</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fpan.13134$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fpan.13134$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28321983$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Thomas, Mark</contributor><creatorcontrib>Veneziano, Giorgio</creatorcontrib><creatorcontrib>Tobias, Joseph D.</creatorcontrib><creatorcontrib>Thomas, Mark</creatorcontrib><title>Chloroprocaine for epidural anesthesia in infants and children</title><title>Pediatric anesthesia</title><addtitle>Paediatr Anaesth</addtitle><description>Summary
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long‐term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics. Chloroprocaine, an ester local anesthetic agent, which is rapidly metabolized in plasma at all ages, is an attractive alternative for this special population, particularly in the presence of superimposed liver impairment or when higher infusion rates are needed for surgical incisions stretching many dermatomes. The current manuscript reviews the literature pertaining to the use of 2‐chloroprocaine for regional anesthesia in infants and children. Dosing regimens are presented and the applications of 2‐chloroprocaine in this population are discussed.</description><subject>Adolescent</subject><subject>analgesia</subject><subject>Analgesia, Epidural</subject><subject>Anesthesia</subject><subject>Anesthesia, Epidural</subject><subject>anesthesia, regional</subject><subject>Anesthetics, Local</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infusion Pumps</subject><subject>Local anesthesia</subject><subject>pediatrics</subject><subject>Procaine - analogs & derivatives</subject><issn>1155-5645</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE9LAzEQxYMotlYPfgFZ8ORh200mSZOLUIr_oKgHPYfsJqEp29016SL99ka3enMYmGH48ebxELrExRSnmnW6mWLAQI_QGFNe5JJJcpx2zFjOOGUjdBbjpigwEE5O0YgIIFgKGKPb5bpuQ9uFttK-sZlrQ2Y7b_qg60w3Nu7WNnqd-Sa1080upqvJqrWvTbDNOTpxuo724jAn6P3-7m35mK9eHp6Wi1VeAQOaO-KAzg2XpTSUEFOSOSnSSQJzwLiTsjBCauBYUyaYK6s50yCdMFyXHBuYoOtBNxn96JMrtWn70KSXCgvJQIDkkKibgapCG2OwTnXBb3XYK1yo76RUSkr9JJXYq4NiX26t-SN_o0nAbAA-fW33_yup18XzIPkF-tNxGA</recordid><startdate>201706</startdate><enddate>201706</enddate><creator>Veneziano, Giorgio</creator><creator>Tobias, Joseph D.</creator><creator>Thomas, Mark</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><orcidid>https://orcid.org/0000-0003-4244-9845</orcidid></search><sort><creationdate>201706</creationdate><title>Chloroprocaine for epidural anesthesia in infants and children</title><author>Veneziano, Giorgio ; Tobias, Joseph D. ; Thomas, Mark</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3534-f2f347d69b9d422db2720f34935f356f990d89a361a4585fbc75a39f8d6ab61d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>analgesia</topic><topic>Analgesia, Epidural</topic><topic>Anesthesia</topic><topic>Anesthesia, Epidural</topic><topic>anesthesia, regional</topic><topic>Anesthetics, Local</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infusion Pumps</topic><topic>Local anesthesia</topic><topic>pediatrics</topic><topic>Procaine - analogs & derivatives</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Veneziano, Giorgio</creatorcontrib><creatorcontrib>Tobias, Joseph D.</creatorcontrib><creatorcontrib>Thomas, Mark</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Pediatric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Veneziano, Giorgio</au><au>Tobias, Joseph D.</au><au>Thomas, Mark</au><au>Thomas, Mark</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chloroprocaine for epidural anesthesia in infants and children</atitle><jtitle>Pediatric anesthesia</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2017-06</date><risdate>2017</risdate><volume>27</volume><issue>6</issue><spage>581</spage><epage>590</epage><pages>581-590</pages><issn>1155-5645</issn><eissn>1460-9592</eissn><abstract>Summary
Continuous epidural infusions are an effective and safe method of providing anesthesia and postoperative analgesia in infants and children with multiple advantages over systemic medications, including earlier tracheal extubation, decreased perioperative stress response, earlier return of bowel function, and decreased exposure to volatile anesthetic agents with uncertain long‐term neurocognitive effects. Despite these benefits, local anesthetic toxicity remains a concern in neonates and infants because of their decreased metabolic capacity for amide local anesthetics. Chloroprocaine, an ester local anesthetic agent, which is rapidly metabolized in plasma at all ages, is an attractive alternative for this special population, particularly in the presence of superimposed liver impairment or when higher infusion rates are needed for surgical incisions stretching many dermatomes. The current manuscript reviews the literature pertaining to the use of 2‐chloroprocaine for regional anesthesia in infants and children. Dosing regimens are presented and the applications of 2‐chloroprocaine in this population are discussed.</abstract><cop>France</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28321983</pmid><doi>10.1111/pan.13134</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-4244-9845</orcidid></addata></record> |
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| ispartof | Pediatric anesthesia, 2017-06, Vol.27 (6), p.581-590 |
| issn | 1155-5645 1460-9592 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adolescent analgesia Analgesia, Epidural Anesthesia Anesthesia, Epidural anesthesia, regional Anesthetics, Local Child Child, Preschool Humans Infant Infant, Newborn Infusion Pumps Local anesthesia pediatrics Procaine - analogs & derivatives |
| title | Chloroprocaine for epidural anesthesia in infants and children |
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