title: Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery.
abstract: BACKGROUND
  Ropivacaine, s-enantiomer of amide local anaesthetic produces differential neural blockade with less motor blockade, cardiovascular and neurological toxicity makes it suitable for day case surgery in children.
  
  
  OBJECTIVE
  To compare the effectiveness of Inj. Ropivacaine (0.2 or 0.25%) or Inj. Bupivacaine (0.25%) with fentanyl in caudal block for intra and postoperative analgesia.
  
  
  METHODS
  Double blind retrospective randomized study.
  
  
  METHODS
  All the patients (n=112) varying from age group 3.02 ± 3.29 years belonging to ASA I-IV were randomly allocated to receive caudal analgesia Group BF inj. Bupivacaine (0.25%, 2 mg/kg) + Inj. Fentany1 μg/kg (n=70) and group RF: Inj. Ropivacaine (0.25% or 0.2%, 2 mg/kg) + inj. Fentanyl 1 μg/kg (n=42). We monitored vitals and requirement of inhalational gases inraoperatively and also observed pain by pain score (Visual Analogue Score in verbal group and Objective Pain Scale in nonverbal group) and vitals postoperatively. We used rescue analgesics (inj. Paracetamol 5 mg/kg iv) when VAS score ≥4.
  
  
  METHODS
  Student's t-test.
  
  
  RESULTS
  Duration of analgesia was prolonged in both group RF and BF. Time for first rescue analgesic for group RF (6.1 ± 1.1 hr) compared to group BF (5.6 ± 0.9 hr). Haemodynamic stability and less requirement of inhalation agent intraoperatively with group RF than others.
  
  
  CONCLUSIONS
  Ropivacaine with Fentanyl found to be better combination for pediatric surgeries for below umbilical surgeries as an adjuvant to general anaesthesia or sole technique with chances of less complication with high success rate.
authors.affiliation: Department of Anesthesia, Byramjee Jeejeebhoy Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Tarlika P
authors.initials: TP
authors.lastname: Doctor
authors.affiliation: Department of Anesthesia, Byramjee Jeejeebhoy Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Divyang B
authors.initials: DB
authors.lastname: Dalwadi
authors.affiliation: Department of Anesthesia, Byramjee Jeejeebhoy Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Lissa
authors.initials: L
authors.lastname: Abraham
authors.affiliation: Department of Anesthesia, Byramjee Jeejeebhoy Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Namrata
authors.initials: N
authors.lastname: Shah
authors.affiliation: Department of Anesthesia, Byramjee Jeejeebhoy Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Indu A
authors.initials: IA
authors.lastname: Chadha
authors.affiliation: Department of Anesthesia, Byramjee Jeejeebhoy Medical College, Civil Hospital, Ahmedabad, Gujarat, India.
authors.forename: Bharat J
authors.initials: BJ
authors.lastname: Shah
keywords: Caudal epidural; local anesthetic agent; opioid adjuvant; post-operative analgesia