Local anesthetics in pediatric anesthesia: an update.

  title={Local anesthetics in pediatric anesthesia: an update.},
  author={Claude Ecoffey},
  journal={Minerva anestesiologica},
  volume={71 6},
For several decades, bupivacaine has enjoyed great clinical popularity as the first choice local anesthetic in pediatrics. However, introduction of ropivacaine and levobupivacaine, the two newer and presumably safer (thought to be less cardio- and neurotoxic than bupivacaine) local anesthetics, has challenged the position of bupivacaine as a gold standard for prolonged duration of analgesia. This review article summarized the metabolism, the criteria of choice and the safety use of new agents.