Comparison of racemic bupivacaine, ropivacaine, and levo-bupivacaine for pediatric caudal anesthesia: Effects on postoperative analgesia and motor block

Giorgio Ivani, Pasquale DeNegri, Alessandra Conio, Roberto Grossetti, Pasquale Vitale, Claudia Vercellino, Ferdinando Gagliardi, Staffan Eksborg, Per Arne Lonnqvist

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)157-161
Number of pages5
JournalRegional Anesthesia and Pain Medicine
Volume27
Issue number2
DOIs
Publication statusPublished - 2002

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Keywords

  • Analgesia
  • Caudal; Bupivacaine; Children; Motor block; Levo-bupivacaine; Ropivacaine
  • Postoperative; Anesthesia
  • Regional

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Ivani, G., DeNegri, P., Conio, A., Grossetti, R., Vitale, P., Vercellino, C., Gagliardi, F., Eksborg, S., & Lonnqvist, P. A. (2002). Comparison of racemic bupivacaine, ropivacaine, and levo-bupivacaine for pediatric caudal anesthesia: Effects on postoperative analgesia and motor block. Regional Anesthesia and Pain Medicine, 27(2), 157-161. https://doi.org/10.1053/rapm.2002.30706