Pharmacokinetics and Pharmacodynamics of Levobupivacaine During Continuous Caudal Epidural Analgesia in Newborns

Inclusion criteria

• Obtained informed consent of parent(s)/legal representative(s)
• Age younger than 45thweek of PMA
• Age older than 25thweek of PMA
• body weight (BW) more than 500g
• Previous or planned operation with great demand on POPM
• Other diseases demanding great POPM (even without any need of surgery)
• Vital functions of the patient will be stable and there will be no suspicion, that patient current condition might be worsen by insertion of c-CELA (every patient will be discussed with attending physician )

Exclusion criteria

• Decline of informed consent by parent(s) legal representative
• Age older than 45thweek of PMA
• Age younger than 25th week of PMA
• body weight (BW) lower than 500g
• Congenital malformation of caudal part of spine ( spina bifida occulta , meningocele, meningomyelocele)
• Disease or congenital malformation significantly restricting liver functions (Elevation of liver enzymes more than twice above the physiological range of the corresponding PMA)
• Disease or congenital malformation significantly restricting kidney functions (Elevation of urea and creatinine enzymes more than twice above the physiological range of the corresponding PMA)
• Clinical condition, which doesn't long-term POPM
• Meningism
• Patients with proven withdrawal syndrome caused by opiate administration
• High risk of bleeding during insertion (coagulopathy) or known administrated anticoagulants which might be still active in the time of insertion of c-CELA
• Substantial anemia (under 90g/l), which could lead to blood transfusion due to blood drawing
• frequent blood tests associated with the treatment of the patient(with blood samples necessary for the purposes of the study together), which would exceed maximum
• any hemodynamically unstable condition (for example septic shock)