Use of levobupivacaine in paediatric surgery

{
  "publication_number": "US5910502A",
  "country": "US",
  "kind": "A",
  "title": "Use of levobupivacaine in paediatric surgery",
  "abstract": "Levobupivacaine is used for providing anaesthesia or analgesia in human paediatric surgery.",
  "claims": [
    "1. A method of providing anaesthesia or analgesia in human paediatric surgery, which comprises the administration of levobupivacaine.",
    "2. The method, according to claim 1, wherein said human is a neonate.",
    "3. The method, according to claim 1, wherein said human is 0.5 to 12 years old.",
    "4. The method, according to claim 1, wherein said administration is by epidural infusion.",
    "5. The method, according to claim 1, wherein said administration comprises an upper or lower extremity block.",
    "6. The method, according to claim 1, for use in post-operative pain control."
  ],
  "description_excerpt": "This invention relates to a new therapeutic use for levobupivacaine or (S)-1-butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide.\n\nRacemic bupivacaine is an effective long-acting anaesthetic, and may be given as an epidural. However, racemic bupivacaine is cardiotoxic, having depressant electrophysiological and mechanical effects on the heart. It should therefore be used with caution in cardiac-compromised patients, and the use of high doses and high concentrations is contraindicated.\n\nIn particular, bupivacaine has produced death in a number of patients, including women in childbirth and when used in the Bier's block technique. Although the incidence of death has been relatively small, the concern has been sufficient to stop the use of 0.75% bupivacaine for obstetrics and the proscribing of bupivacaine for use in Bier's blocks.\n\nIn addition, due to its mode of action, directly on the nervous system, at higher doses, bupivacaine is known to have undesirable central nervous system (CNS) side-effects which, prima facie, are connected to its anaesthetic activity. Indeed, the occurrence of CNS side-effects is one of the major factors limiting the use of this drug in normal clinical practice employing techniques such as local infiltration, nerve block, field block, epidural and spinal blocks.\n\nIt has been suggested that levobupivacaine is less cardiotoxic than dextrobupivacaine and racemic bupivacaine. See, for example, Vanhoutte et al, Br. J. Pharmacol. 103: 1275-1281 (1991), and Denson et al, Regional Anaesthesia, 17: 311-316 (1992).",
  "cpc": [
    "A61K 31/445",
    "A61P 23/00",
    "A61P 23/02",
    "A61P 25/04",
    "A61P 29/00"
  ],
  "ipc": [
    "A61K 31/445",
    "A61P 23/02",
    "A61P 25/04"
  ],
  "assignees": [
    "Darwin Discovery Ltd"
  ],
  "inventors": [
    "Brian Albert Gennery"
  ],
  "filing_date": "1998-03-03",
  "publication_date": "1999-06-08",
  "grant_date": "1999-06-08",
  "priority_date": "1997-03-03",
  "application_number": "US-3407098-A",
  "family_id": "10808602",
  "cited_by_count": 48,
  "citations": [
    "US5708011A"
  ]
}