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Indian Journal of Anesthesia and Analgesia

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A Randomized Prospective Double Blind Comparative Study of Caudal Ropivacaine 0.2% versus Caudal Bupivacaine 0.125% for Postoperative Analgesia in Pediatric Surgeries

Surekha S. Chavan, Associate Professor, Department of Anesthesiology, B.J. Government Medical College and Sassoon General Hospital, Pune, Maharashtra 411001, India. , Surekha S. Chavan1 , S.V. Naik2 , A.A. Raghuvanshi3 , B. Kawade4

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Indian Journal of Anesthesia and Analgesia 5(6):p 1027-1033, June 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.24

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Abstract

Introduction: Pain relief is important for reduction of postoperative morbidity necessitating continuing search for safe and efficient method in pediatric patients due to difficulty in pain assessment and concern of potential side effects. Single dose caudal epidural block is simple, effective and easy technique to perform due to anatomy of sacrum of child. There are reports of ropivacaine/bupivacaine being used routinely for  caudal anaesthesia (Bramwell, Kapsten) and the extension of its analgesic action in the postoperative period.

Aims & Objectives: To study and compare the effects of caudal ropivacaine and caudal bupivacaine for postoperative analgesia in pediatric patients w.r.t. duration and quality of postoperative analgesia, duration of motor blockade, hemodynamic effects and adverse  effects if any.

Methods: Comparative double blind prospective study included 100 patients of ASA grade I/II in age group of 2 years to 12 years posted for elective surgeries ( circumcision, herniotomy, hydrocoele repair etc). General anesthesia was given followed by a single shot caudal epidural in the left lateral position after completion of surgery. They were  randomly divided into two groups of 50 each, Group B – 0.2% ropivacaine 0.75 ml/kg. Group A – 0.125% bupivacaine 0.75 ml/kg.

Results: The mean duration of analgesia using caudal ropivacaine was 5.43 hrs and caudal bupivacaine was 5.38 hrs. The mean duration of motor blockade with caudal bupivacaine was prolonged 6.10 hrs and caudal ropivacaine was 3.16 hrs. No hemodynamic instability and adverse effects.

Conclusion: 1. caudal ropivacaine showed quality and duration of postoperative analgesia comparable to that of caudal bupivacaine. 2. The duration of motor blockade with caudal ropivacaine was short as compared to that of caudal bupivacaine 3.  Hemodynamic parameters were stable. 4. No any adverse effects.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5618.24

Keywords

Postoperative Analgesia; Pediatric Surgery; Technique-Caudal Block; Drug-Bupivacaine/ Ropivacaine.

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