Comparison of Efficacy between 0.25% Bupivacaine and 0.25% Levobupivacaine for Caudal Anaesthesia in Paediatric Infraumbilical Surgeries
Abstract
Regional anesthesia in paediatrics has been an evolving trend with the advent of newer drugs and techniques in terms of both safety and efficacy. The aim of this study was to compare effectiveness of local anaesthetic drugs – bupivacaine and levobupivacaine on duration of analgesia and post operative pain in paediatric population who underwent below umbilical surgeries.
Aim: Comparing the duration of analgesia between 0.25% levobupivacaine and 0.25% bupivacaine was the main goal. The comparison of hemodynamic parameters, the length of motor blockade, and the frequency of side effects between 0.25% bupivacaine and 0.25% levobupivacaine were the secondary goals.
Method: 70 patients were included in this randomized control study. The patients were allocated into two groups: the levobupivacaine (group A, n = 35) and the Bupivacaine group (group B, n = 35). All patients were given caudal
block after minimal sedation before the surgery with either 0.25% levobupivacaine and 0.25% bupivacaine of 0.75ml/kg and duration of analgesia and motor residual blockade, intra operative and post operative hemodynamic parameters and the incidence of adverse events if any occurred were studied
Results: Levobupivacaine provided more duration of analgesia 131.37 ± 4.023 minutes compared to bupivacaine 124.06 ± 2.807 minutes in terms of both efficacy and quality .Levobupivacaine has lesser residual motor blockade when compared with bupivacaine at wakeup (Modified Bromage>1) with p value (P = 0.037) and 180mins using modified bromage scale.There was no difference in the hemodynamic parameters between the two groups signifying the drugs are hemodynamically stable. No adverse reactions were noted during our study empathize the safety of the usage of drugs in the paediatric population.
Conclusions: Levobupivacaine comparatively had higher efficacy in terms of duration of analgesia and lesser motor blockade compared to bupivacaine for paediatric infra umbilical surgeries
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