Comparison of Racemic Bupivacaine, Ropivacaine, and Levo-Bupivacaine for Pediatric Caudal Anesthesia: Effects on Postoperative Analgesia and Motor Block. Issue 2 (1st March 2002)

• Record Type: Journal Article
• Authors: Ivani, Giorgio; DeNegri, Pasquale; Conio, Alessandra; Grossetti, Roberto; Vitale, Pasquale; Vercellino, Claudia; Gagliardi, Ferdinando; Eksborg, Staffan; Lonnqvist, Per-Arne
• Is Part Of: Regional anesthesia and pain medicine. Volume 27:Issue 2(2002)
• Page Start: 157
• Page End: 161
• Publication Date: 2002-03-01
• Subjects: Analgesia -- postoperative; Anesthesia -- regional -- caudal; Bupivacaine; Children; Motor block; Levo-bupivacaine; Ropivacaine; Conduction anesthesia -- Periodicals; Pain medicine -- Periodicals; 617.964
• DOI: 10.1053/rapm.2002.30706
• Languages: English
• ISSNs: 1098-7339

Abstract

Abstract : Background and Objectives: To compare ropivacaine, levo-bupivacaine, and racemic bupivacaine for caudal blockade in children. Methods: Using a prospective observer blinded design, 60 sevoflurane anesthetized children (1 to 7 years) undergoing minor subumbilical surgery, were randomized to receive a caudal block (1 mL/kg) with either ropivacaine 0.2%, racemic bupivacaine 0.25%, or levo-bupivacaine 0.25%. Postoperative analgesia (number of patients needing supplemental analgesia as defined by an objective pain score [OPS] score of ≥ 5; time to first analgesic demand) during the first 24 postoperative hours was chosen as the primary end-point. Early postoperative motor block (3-point scale) was assessed as a secondary end-point. Results: All blocks were judged to be clinically successful based on the presence of adequate intraoperative and early postoperative analgesia. An OPS score ≥ 5 was found in 5/20 patients in each study group. No difference regarding the time to first analgesic demand was found between the study groups. The use of ropivacaine ( P = .02), but not levo-bupivacaine ( P = .18), was found to be associated with less motor block during the first postoperative hour compared with racemic bupivacaine. Conclusion: All 3 investigated local anesthetics were found to be clinically comparable despite the slight reduction of early postoperative motor block associated with the use of ropivacaine.