A comparison of three different concentrations of levobupivacaine for caudal block in children

Giorgio Ivani, Pasquale De Negri, Per Arne Lonnqvist, Staffan Eksborg, Valeria Mossetti, Roberto Grossetti, Simona Italiano, Franca Rosso, Federica Tonetti, Luigi Codipietro

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We investigated three different concentrations of levobupivacaine (0.125%, 0.20%, and 0.25%; n = 20 in each group) for caudal blockade in a prospective, randomized, observer-blinded fashion in children (1-7 yr) undergoing subumbilical surgery. The duration of postoperative analgesia was assessed as the time to first administration of supplemental analgesia (based on a Childrens and Infants Postoperative Pain Scale score of ≥4), and the degree of immediate postoperative motor blockade was determined by use of a 3-point scale. A dose-response relationship was observed both with regard to median duration of postoperative analgesia (0.125%, 60 min; 0.20%, 118 min; 0.25%, 158 min) and the number of patients with evidence of early postoperative motor blockade (0.125%, 0; 0.20%, 4; 0.25%, 8). The 0.125% concentration was associated with significantly less early motor blockade (P = 0.003) but was found to result in a significantly shorter duration of postoperative analgesia (P <0.05). Based on these results, the use of 0.20% levobupivacaine might represent the best clinical option if a plain levobupivacaine solution is to be used for caudal blockade in children.

Original languageEnglish
Pages (from-to)368-371
Number of pages4
JournalAnesthesia and Analgesia
Issue number2
Publication statusPublished - Aug 1 2003

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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