title: Comparative study of ultrasound-guided paravertebral block with ropivacaine versus bupivacaine for post-operative pain relief in children undergoing thoracotomy for patent ductus arteriosus ligation surgery.
abstract: OBJECTIVE
  Thoracotomy incision following patent ductus arteriosus (PDA) ligation surgery is often associated with severe post-operative pain that has deleterious effects on respiratory function. We aimed to assess pain relief with thoracic paravertebral block using either bupivacaine or ropivacaine in these surgeries.
  
  
  METHODS
  One hundred paediatric patients of age group between 2 and 10 years undergoing PDA ligation surgery were randomised either to bupivacaine or ropivacaine group in this prospective double-blinded study. After induction of general anaesthesia, the ultrasound-guided paravertebral block was carried out using 0.25% bupivacaine 0.4 ml/kg in Group B patients and 0.2% ropivacaine 0.4 ml/kg in Group R patients. Monitoring included minimum mandatory monitoring with pulse rate, pulseoximetry (SpO2), electrocardiogram, blood pressure, temperature during surgery and also in Intensive Care Unit (ICU). Additionally, modified objective pain score (MOPS) was used in ICU for assessment of pain for 12 h after surgery. Incidence of complications was noted.
  
  
  RESULTS
  Mean values of MOPSs were comparable in both the groups. The time to rescue analgesic was 8 to 10 h in over 80% of patients in both the groups. More patients had hypotension and bradycardia in bupivacaine group compared to ropivacaine group.
  
  
  CONCLUSIONS
  Paravertebral injection of 0.4 ml/kg of either 0.2% ropivacaine or 0.25% bupivacaine provided equipotent analgesia, but ropivacaine had a better side effect profile. Ultrasound-guided paravertebral block is a safe and effective mode of analgesia in paediatric patients undergoing thoracotomy.
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India.
authors.forename: Kolli S
authors.initials: KS
authors.lastname: Chalam
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India.
authors.forename: Sathya Swaroop
authors.initials: SS
authors.lastname: Patnaik
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India.
authors.forename: C
authors.initials: C
authors.lastname: Sunil
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, Sri Sathya Sai Institute of Higher Medical Sciences, Bengaluru, Karnataka, India.
authors.forename: Tripti
authors.initials: T
authors.lastname: Bansal
keywords: Bupivacaine; post-thoracotomy pain; ropivacaine; ultrasound-guided paravertebral block