Indian Journal of Clinical Anaesthesia


A randomized double-blinded comparative study of 0.25% Ropivacaine and 0.25% Bupivacaine by Caudal epidural for Paediatric sub-umbilical surgeries


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Author Details: Sendhil Kumar Mohan, R. Selvakumar, M. Suresh, K. Chandran

Volume : 3

Issue : 4

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 593

Article End Page : 598


Abstract

Background & Objectives: Bupivacaine is the most frequently used local anaesthetic for caudal anaesthesia in children. Ropivacaine provides pain relief similar to bupivacaine with lesser motor blockade and cardiotoxicity. To compare caudal 0.25% ropivacaine and 0.25% bupivacaine in terms of the quality and duration of analgesia, motor and sensory block for sub-umbilical surgeries in children.
Materials & Methods: In a double-blinded randomized comparative study, 60 children aged 3-8 years were randomly allocated to receive a presurgical caudal injection of 0.75ml/kg of either 0.25% Ropivacaine (Group R) or 0.25% Bupivacaine (Group B) after induction of general anaesthesia. Apart from monitoring the vital parameters, all children were assessed for postoperative analgesia by Hannallah pain scale and for motor blockade by Motor power score. The time for full sensory recovery was also observed.
Results: The groups were comparable for age, sex, weight, height, vital signs, duration and type of surgery. The duration of postoperative pain relief did not differ between the two groups (338.83±44.75 min (group R) Vs 346.67±51.06 min (group B). The motor blockade recovered quickly in group R (113.50±10.18 min) than in group B (128.50±17.48 min) P<0.001. The time for full sensory recovery was similar for both the groups (77.50±2.67 min in group R vs 80.00±7.19 min in group B).
Conclusion: Caudal 0.25% ropivacaine provided good quality of analgesia with significantly faster motor recovery than 0.25% bupivacaine, allowing the children to be discharged earlier.

Keywords:
Caudal epidural, Ropivacaine, Bupivacaine, Hannallah pain score, Motor block, Post-op analgesia

Doi No:-10.18231