{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T13:15:59Z","timestamp":1773321359370,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,3,10]],"date-time":"2015-03-10T00:00:00Z","timestamp":1425945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Administration of local anesthetics by a surgically placed wound catheter has recently been shown to reduce the need for postoperative morphine administration in extremely preterm infants undergoing ductus ligation. The primary aim of this randomized safety study was to define the plasma levels of levobupivacaine (<jats:styled-content style=\"fixed-case\">LB<\/jats:styled-content>) following two different intermittent infusion regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighteen preterm infants 23\u201327 gestational weeks, median birthweight 721\u00a0g scheduled for ductus ligation were included in the study. All patients were anesthetized according to a standardized protocol based on high\u2010dose fentanyl (25\u201350\u00a0\u03bcg\u00b7kg<jats:sup>\u22121<\/jats:sup>). Before skin closure, a subcutaneous catheter was inserted into the wound. The patients were randomized to receive one of the two intermittent infusion regimens: Group <jats:styled-content style=\"fixed-case\">BII<\/jats:styled-content>: Initial bolus plus early start of the intermittent infusion or Group <jats:styled-content style=\"fixed-case\">DII<\/jats:styled-content>: No bolus plus delayed start (8\u00a0h) of the intermittent infusion. Blood samples for determination of <jats:styled-content style=\"fixed-case\">LB<\/jats:styled-content> plasma concentrations were obtained on six occasions during the 24\u2010h postoperative observation period, as well as hourly postoperative pain assessments using the Echelle Douleur Inconfort Noveau (<jats:styled-content style=\"fixed-case\">EDIN<\/jats:styled-content>) pain scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Plasma concentrations of <jats:styled-content style=\"fixed-case\">LB<\/jats:styled-content> ranged from 0.094 to 1.682\u00a0\u03bcg\u00b7ml<jats:sup>\u22121<\/jats:sup> and 0 to 0.549\u00a0\u03bcg\u00b7ml<jats:sup>\u22121<\/jats:sup> in group <jats:styled-content style=\"fixed-case\">BII<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DII<\/jats:styled-content>, respectively. Both regimens were associated with low postoperative <jats:styled-content style=\"fixed-case\">EDIN<\/jats:styled-content> pain scores (24\u00a0h median of 0 and 1 in group <jats:styled-content style=\"fixed-case\">BII<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DII<\/jats:styled-content>, respectively). No signs of systemic local anesthetic toxicity were noted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The two studied intermittent infusion regimens were associated with plasma levels below potentially toxic levels and were both associated with adequate postoperative pain scores.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12634","type":"journal-article","created":{"date-parts":[[2015,3,10]],"date-time":"2015-03-10T06:58:58Z","timestamp":1425970738000},"page":"711-718","source":"Crossref","is-referenced-by-count":17,"title":["Plasma concentrations of levobupivacaine associated with two different intermittent wound infusion regimens following surgical ductus ligation in preterm infants"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6915-4567","authenticated-orcid":false,"given":"Marie","family":"Anell\u2010Olofsson","sequence":"first","affiliation":[{"name":"Department of Neonatology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per\u2010Arne","family":"L\u00f6nnqvist","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anaesthesia, Intensive Care and ECMO Services Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catarina","family":"Bitkover","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Lundeberg","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anaesthesia, Intensive Care and ECMO Services Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn A.","family":"Larsson","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anaesthesia, Intensive Care and ECMO Services Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Staffan","family":"Eksborg","sequence":"additional","affiliation":[{"name":"Department of Neonatology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Bartocci","sequence":"additional","affiliation":[{"name":"Department of Neonatology Karolinska University Hospital Stockholm 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