title: A prospective study comparing the analgesic efficacy of levobupivacaine, ropivacaine and bupivacaine in pediatric patients undergoing caudal blockade.
abstract: 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.
authors.affiliation: Department of Anaesthesia, LKH Klagenfurt, Klagenfurt, Austria. breschan.ch@chello.at
authors.forename: Christian
authors.initials: C
authors.lastname: Breschan
authors.forename: Robert
authors.initials: R
authors.lastname: Jost
authors.forename: Ruth
authors.initials: R
authors.lastname: Krumpholz
authors.forename: Florian
authors.initials: F
authors.lastname: Schaumberger
authors.forename: Haro
authors.initials: H
authors.lastname: Stettner
authors.forename: Peter
authors.initials: P
authors.lastname: Marhofer
authors.forename: Rudolf
authors.initials: R
authors.lastname: Likar
mesh_terms: 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
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D010100:Oxygen; D002045:Bupivacaine