A comparative study of ropivacaine 0.25% versus levobupivacaine 0.25% with dexamethasone in caudal block for postoperative analgesia in pediatric patients

Background and Aims: Caudal epidural block is one of the most popular, reliable, and safe techniques in pediatric analgesia that can be used with general anesthesia for intra and postoperative analgesia in patients undergoing infraumbilical surgeries. The aim of this study was to compare ropivacaine 0.25% versus levobupivacaine 0.25% with dexamethasone in caudal block for duration of analgesia. Methodology: Hundred patients, aged 6 months to 6 years of ASA physical status I and II were randomly allocated in two groups in this prospective randomized double-blind study. Group RD ( n = 50) received caudal 0.25% ropivacaine 1 ml/kg + dexamethasone 0.1 mg/kg, while Group LD ( n = 50) received 0.25% levobupivacaine 1 ml/kg + dexamethasone 0.1 mg/kg in caudal block. The duration of analgesia, total number of doses of rescue analgesia consumed in 24 h, hemodynamics, and side effects were noted. Results: Duration of analgesia was 584.42 ± 84.21 min in group RD and 602.84 ± 85.48 min in group LD, which was not significant ( P -value = 0.280). No significant difference was found for total number of doses of rescue analgesic consumption in 24 hours in both groups ( P -value = 0.481). Both groups were comparable with respect to hemodynamics and side effects ( P- value > 0.05). Conclusion: Addition of dexamethasone 0.1 mg/kg with ropivacaine 0.25% and levobupivacaine 0.25% for caudal block in pediatric patients having a similar clinical profile in both groups prolongs the duration of analgesia and decreases the analgesic consumption in 24 hours with stable hemodynamics and minimal side effects.