Korean J Anesthesiol.  2014 Jun;66(6):457-461. 10.4097/kjae.2014.66.6.457.

A randomized-controlled, double-blind comparison of the postoperative analgesic efficacy of caudal bupivacaine and levobupivacaine in minor pediatric surgery

• Sen A
• Colak MS
• Erturk E
• Tomak Y

• KMID: 2237951
• DOI: http://doi.org/10.4097/kjae.2014.66.6.457

Abstract

BACKGROUND
We compared the postoperative analgesic efficacy of caudal levobupivacaine with bupivacaine in pediatric subumbilical surgery.
METHODS
Sixty American Society of Anesthesiologists I-II patients scheduled for elective minor surgery (1.5-7 years old) were randomly divided into three groups to receive caudal injections of study drugs at 0.5 ml/kg. All patients received 0.1 mg/kg oral midazolam 30 min before surgery. Group B received 0.125% bupivacaine, group L received 0.125% levobupivacaine, and group LF received 0.125% levobupivacaine + 0.5 microg/kg fentanyl. Blood pressure, heart rate and sedation (using a four-scale sedation score) were monitored perioperatively. During the postoperative period, an anesthesiologist blinded to the study groups used the Children's and Infants' Postoperative Pain Scale to monitor patients' pain and degree of sedation. The time before the first rescue analgesic was recorded as well as any side effects over the next 24 h.
RESULTS
The four-scale sedation and postoperative pain scale scores in all groups were identical. Blood pressure and heart rate measured at 15 min postoperatively were lower, and time to first rescue analgesic was longer, in Group LF compared to the others.
CONCLUSIONS
Caudal 0.5 ml/kg of 0.125% bupivacaine and levobupivacaine are equally effective for postoperative analgesia after subumbilical surgeries in pediatric patients. Addition of fentanyl may lower the required amount of local anesthetics.

Keyword

Bupivacaine; Epidural analgesia; Fentanyl; Levobupivacaine; Minor surgical procedures; Pediatrics

MeSH Terms

Analgesia
Analgesia, Epidural
Anesthetics, Local
Blood Pressure
Bupivacaine*
Fentanyl
Heart Rate
Humans
Midazolam
Pain, Postoperative
Pediatrics
Postoperative Period
Surgical Procedures, Minor
Anesthetics, Local
Bupivacaine
Fentanyl
Midazolam