COMPARATIVE EVALUATION OF 0.25% BUPIVACAINE TO 0.25% ROPIVACAINE FOR CAUDAL ANESTHESIA DURING INFRA UMBILICAL SURGERIES IN PEDIATRIC SUBJECTS

Abstract

Background: In pediatric subjects, caudal epidural anesthesia is most commonly used to manage postoperative pain.
The caudal epidural is most commonly used in surgeries of lower extremities, inguinal, rectal, and/or urogenital areas.
Aims: The present study was conducted to compare and assess the efficacy of 0.25% Bupivacaine to 0.25% ropivacaine
for caudal Anesthesia during infra umbilical surgeries in pediatric subjects. Methods: In 56 subjects with ASA status, I
and II, who had to undergo elective surgeries of infraumbilical region were included in the study and were randomly
treated with either 0.25% ropivacaine or 0.25% bupivacaine in the dose of 1ml/kg. Bromage motor scale was used to
assess motor block postoperatively and observer pain scale to assess analgesia. The collected data were subjected to
statistical evaluation and the results were formulated. Results: Time taken to reach Bromage motor block stage 0 was
4 hours in 14.28% (n=4) subjects from Group I and 21.42% (n=6) subjects from group II, whereas, the time taken to reach
a score of zero was 4.5 hours in 85.71% (n=240 subjects from group I and 78.57% (n=22) subjects from group II. This
difference was statistically significant with p<0.0001. The mean motor block duration was significantly higher in group
I compared to group II with respective values of 236.2±1.87 and 204.02±2.19 minutes. This was higher for Group I with
bupivacaine compared to ropivacaine Group II with p<0.0001. The score was 0 at 4 hours in 14.28% (n=4) subjects from
Group I and 64.28% (n=18) subjects from Group II. The duration of analgesia was 266.2±1.87 mins for Group I and
251.2±2.66 mins for Group II which was significantly higher for bupivacaine compared to ropivacaine p<0.0001.
Conclusion: The present study concludes that caudal epidural anesthesia using 0.25% bupivacaine resulted in a better
motor block and longer duration analgesia compared to ropivacaine at 0.25%. However, no difference was seen for sideeffects and hemodynamic parameters.