Caudal Analgesia In Paediatric Patients: Comparision Between Bupivacaine And Ropivacaine

Introduction: Caudal block since its first description in 1933 for paediatric urological interventions has evolved to become the most popular regional anesthetic technique for use in children. It provides excellent analgesia during surgery as well as during postoperative period in subumblical surgeries in children. This randomised prospective controlled study was undertaken to find and compare quality and duration of analgesia, motor and sensory block after a single shot caudal block with either Bupivacaine or Ropivacaine.Method: 60 ASA I-II patients in the age range -12 years scheduled for Elective subluminal procedures were enrolled. Standard anaesthetic induction was conducted in all patients. After induction caudal block was performed in the lateral position. Perioperative haemodynamic parameters were recorded. Patients were randomly allocated to one of the two groups of 30 patients each. Group A received 1ml/kg of 0.25% bupivacaine. Group B received 1ml/kg of 0.2% ropivacaine.Results: Post operative pain score was comparable in two groups in the first 4 hours but it was significantly less in ropivacaine group after 4 hour. The mean duration of analgesia in group A was 7.4±1.0 hours while in group B mean duration of analgesia was 7.6±1.3 hours. 19 patients (63.3%) in group A received rescue analgesic as compared to 10 (33.3%) patients in group B during 12 hour study period. Conclusion: Caudal ropivacaine provides effective post-operative analgesia and possessing less motor blockade makes it a suitable agent for day care surgery with increased margin of safety particularly in younger children