Levobupivacaine
Generic name
Levobupivacaine
Brand name
ATC Code
N01BB10
- Dosages
- Side effects in children
- Warnings & precautions in children
- Contra-indications in children
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Interactions - PK
- Renal impairment
- References
Pharmacokinetics in children
The pharmacokinetic properties of levobupivacaine are similar to that of bupivacaine; both extensively metabolized in the liver, and excreted in the urine and faeces [SmPC Levobupicavaine RVG 115877]
dose recommendation of formulary compared to licensed use (on-label versus off-label)
No information is present at this moment.
Available formulations
No information is present at this moment.
Dosages
Go to:
| Spinal anesthesia |
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| Epidural anaesthesia |
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| (Peripheral) nerve block |
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| Local anesthesia, field block |
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Renal impaiment in children > 3 months
No data are available regarding patients with renal insufficiency. Levobupivacaine is extensively metabolized and unchanged levobupivacaine is not excreted in the urine [SmPC Bupivacaine RVG 115877].
The complete list of all undesirable drug reactions can be found in the national Summary of Product Characteristics (SmPC) – click here
Side effects in children
Levobupivacaine can cause the same side effects as racemic bupivacaine and other local anesthetics. However, it may result in lower cardiac toxicity, neurological injury after peripheral nerve blockade, and adverse CNS effects compared to bupivacaine [Verma 2014, Gupta 2014, Patel 2006].
The complete list of all contra-indications can be found in the national Summary of Product Characteristics (SmPC) – click here
Contra-indications
No information available on specific contra indications in children.
The complete list of all warnings and precautions can be found in the national Summary of Product Characteristics (SmPC) – click here
Warnings & precautions in children
Monitoring using a saturation meter, respiration ECG monitor, and blood pressure measurement, as well as a bladder catheter for micturition disorders.
To avoid excessive dosage in obese patients, dose should be calculated on the basis of ideal body-weight.
Interactions
The complete list of all interactions can be found in the national Summary of Product Characteristics (SmPC) – click here
ANESTHETICS, LOCAL
This pages provides a list of drugs from the same ATC class for comparison. This does not necessarily mean that these drugs are interchangeable.
| Amides | ||
|---|---|---|
| N01BB08 | ||
| N01BB01 | ||
| N01BB02 | ||
| N01BB52 | ||
| N01BB20 | ||
| N01BB52 | ||
| N01BB03 | ||
| N01BB04 | ||
| N01BB09 | ||
| Esters of benzoic acid | ||
|---|---|---|
| N01BC01 | ||
| ESTERS OF BENZOIC ACID | ||
|---|---|---|
| N01BC01 | ||
References
- AbbVie BV, SmPC Chirocaine (RVG 24617) 19 nov 2014, www.cbg-meb.nl
- Wiegele, M.,et al., Caudal epidural blocks in paediatric patients: a review and practical considerations, British journal of anaesthesia, 2019, 122(4), 509–517
- Luz, G.,et al, Bupivacaine plasma concentrations during continuous epidural anesthesia in infants and children., Anesthesia and analgesia, 1996, 82(2), 231–234
- Verma, D.,et al., Spinal anesthesia in infants and children: A one year prospective audit, Anesthesia, essays and researches, 2014, 8(3), 324–329
- Rochette, A. et al., Cerebrospinal fluid volume in neonates undergoing spinal anaesthesia: a descriptive magnetic resonance imaging study, BJA, 2016, 117(2), 214–219
- L. Molteni & C. dei F.lli Alitti Società di Esercizio S.p.A., SmPC Levobupivacaine 2.5/5.0 mg/ml oplossing voor injectie. (RVG 115877/115878) 16-07-2020, www.geneesmiddeleninformatiebank.nl
- López, T., et al., Spinal anesthesia in pediatric patient, Minerva anestesiologica, 2012, 78(1), 78–87
- Patel, D., Epidural analgesia for children, Continuing Education in Anaesthesia Critical Care & Pain, 2006, 6(2), 63–66
- Jöhr M., Regional anaesthesia in neonates, infants and children: an educational review., European journal of anaesthesiology, 2015, 32(5), 289–297
- Suresh, S., et al.., The European Society of Regional Anaesthesia and Pain Therapy/American Society of Regional Anesthesia and Pain Medicine Recommendations on Local Anesthetics and Adjuvants Dosage in Pediatric Regional Anesthesia., Regional anesthesia and pain medicine, 2018, 43(2), 211–216
- Meunier, J. F., et al., Pharmacokinetics of bupivacaine after continuous epidural infusion in infants with and without biliary atresia., Anesthesiology, 2001, 95(1), 87–95
- Calder, A. et al, Pharmacokinetic profiles of epidural bupivacaine and ropivacaine following single-shot and continuous epidural use in young infants, Paediatric anaesthesia, 2012, 22(5), 430–437
- Luz, G.,et al, Free and total bupivacaine plasma concentrations after continuous epidural anaesthesia in infants and children, Paediatric anaesthesia, 1998, 8(6), 473–478
- Mazoit, J. X., et al., Pharmacokinetics of bupivacaine following caudal anesthesia in infants., Anesthesiology, 1988, 68(3), 387–391
- Ecoffey, C. et al, Bupivacaine in children: pharmacokinetics following caudal anesthesia., Anesthesiology, 1985, 63(4), 447–448
- Shah, R. D., et al, Applications of regional anaesthesia in paediatrics. , British journal of anaesthesia,, 2013, 111(1), i114–i124
- Gupta A, et al, Spinal anesthesia in children: A review., J Anaesthesiol Clin Pharmacol., 2014, 30(1), 10-8
- Patel D., Epidural analgesia for children., Continuing Education in Anaesthesia Critical Care & Pain, 2006, 6(2), 63-6
- Meunier, J. F., et al., Pharmacokinetics of bupivacaine after continuous epidural infusion in infants with and without biliary atresia., Anesthesiology, 2001, 95(1), 87–95
- Ecoffey, C. et al, Bupivacaine in children: pharmacokinetics following caudal anesthesia., Anesthesiology, 1985, 63(4), 447–448
- Shah, R. D., et al, Applications of regional anaesthesia in paediatrics., British journal of anaesthesia,, 2013, 111(1), i114–i124
Changes
Therapeutic Drug Monitoring
Overdose
