A prospective study comparing the analgesic efficacy of levobupivacaine, ropivacaine and bupivacaine in pediatric patients undergoing caudal blockade.
BACKGROUND
The aim of our study was to compare postoperative analgesic efficacy, analgesic duration and motor blockade of levobupivacaine, ropivacaine and bupivacaine administered caudally in equal concentrations to children undergoing elective minor surgery.


METHODS
In the study, 182 children, aged 1-7 years, undergoing either inguinal hernia repair or orchidopexy, were randomly allocated to one of the three groups. They received via a caudal extradural either 1 ml x kg(-1) levobupivacaine 0.2% (Group L) or 1 ml x kg(-1) ropivacaine 0.2% (Group R) or 1 ml x kg(-1) bupivacaine 0.2% (Group B).


RESULTS
No statistically significant difference was noted in age, weight, duration of the operation or level of the caudal block between the groups. The onset of analgesia was significantly later after levobupivacaine. Postoperative pain scoring evaluated with Children's and Infant's Postoperative Pain Scale observational scale showed no statistical difference between groups. Median postoperative analgesia was 5.75 h (SEMed: +/- 0.65) in Group L, 5.7 h (SEMed: +/- 0.8) in Group R and 5.35 h (SEMed: +/- 1.3) in Group B the difference being statistically nonsignificant.


CONCLUSIONS
The degree of motor block was significantly less after ropivacaine and levobupivacaine during the first 2 h postoperatively.
Breschan
Christian
C
Department of Anaesthesia, LKH Klagenfurt, Klagenfurt, Austria. breschan.ch@chello.at
Jost
Robert
R
Krumpholz
Ruth
R
Schaumberger
Florian
F
Stettner
Haro
H
Marhofer
Peter
P
Likar
Rudolf
R
D000577:Amides / Q000009:adverse effects; D000763:Anesthesia, Caudal / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects; D002045:Bupivacaine / Q000009:adverse effects / Q000737:chemistry; D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D009046:Motor Neurons / Q000187:drug effects; D009407:Nerve Block / Q000009:adverse effects; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D011446:Prospective Studies; D000077212:Ropivacaine; D013237:Stereoisomerism; D013737:Testis / Q000601:surgery
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D010100:Oxygen; D002045:Bupivacaine