A Comparative Study of 0.25% Levobupivacaine, 0.25% Ropivacaine, and 0.25% Bupivacaine in Paediatric Single Shot Caudal Block

Sharma, Jagdeep; Gupta, Rajesh; Kumari, Anita; Mahajan, Lakshmi; Singh, Jasveer

doi:10.1155/2018/1486261

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…The expected adverse reactions were inadequate analgesia, local reaction to the anaesthetic, and delayed urine derivation in the post-operative period (albeit very rare in children). However, adverse reactions were not reported, which is in line with previous studies (7,9,20,21).…”

Section: Interpretation Of the Study Resultssupporting

confidence: 91%

4. Comparison of the Postoperative Analgesic Effects of Levobupivacaine Wound Instillation with a Placebo after Unilateral Inguinal Hernia Repair: a Randomized-controlled Trial

Šujica

2021

Central Eur J Paed

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Objective − To compare the effectiveness and safety of wound instillation with levobupivacaine with a placebo, in children who underwent inguinal hernia repair, for pain relief. The secondary objective was to examine the frequency of postoperative analgesic mixture (paracetamol/ibuprofen) use. Methods − Single center randomized placebo-controlled trial. Paediatric teaching hospital in Belgrade, Serbia. This study included 100 children who underwent elective surgery for unilateral inguinal hernia. Children were randomized by simple randomization into two groups (N=50 in the experimental group, N=50 in the control group). A solution of 0.5% levobupivacaine, 0.5 mg/kg (0.1 ml/kg) was instilled into the wounds of children in the experimental group before suturing the abdominal fascia. The same amount of 0.9% saline was administered to the children in the control group. The primary outcome was the level of postoperative pain after coming round from general anesthesia (t0) and at 2h, 6h, 12h, 18h and 24h after surgery. The FLACC (Face, Legs, Activity, Cry, Consolability) scale was used to assess the level of pain. The secondary outcome was the frequency of paracetamol/ibuprofen use for pain relief after surgery. Results − Out of the total number of children (100), 70% were boys (70) and 30% were girls (30), and their average age was 3.5±1.9 years. The average duration of surgical intervention in both groups was 31.6±4.2 minutes. Significantly fewer children in the experimental group reported pain (FLACC ≥1) at 2h (P=0.032) and 6h (P=0.001) after surgery, compared to the children in the control group (8 vs. 17 at 2h after surgery; 4 vs. 14 at 6h after surgery). Significantly fewer children in the control group reported sensations of pain that required administration of analgesics 6h after surgery (FLACC >3) compared to the control group (P=0.001) (1 vs. 14). Overall, significantly fewer children in the experimental group received a paracetamol/ibuprofen mixture for pain relief after surgery, compared to the children in the control group (P<0.001) (4 vs. 50). The average daily amount of acetaminophen in the experimental group was 28±127 mg/kg/day and ibuprofen 5.6±1.8 mg/kg/day, while in control group, acytaminophen 42.5±7.7 mg/kg/day and ibprofen 11.5±4 mg/kg/day. The total amount of analgesics was highly statistically significantly lower in the experimental group (P<0.001). Conclusion − Instillation of levobupivacaine before wound suturing in children who had undergone elective inguinal hernia surgery repair was effective in postoperative pain relief. Children who received levobupivacaine also received less of the paracetamol/ibuprofen mixture to relieve their pain over 24 hours after surgery.

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Section: Interpretation Of the Study Resultssupporting

confidence: 91%

4. Comparison of the Postoperative Analgesic Effects of Levobupivacaine Wound Instillation with a Placebo after Unilateral Inguinal Hernia Repair: a Randomized-controlled Trial

Šujica

2021

Central Eur J Paed

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“…The studies done by Chipde et al 6 , Ray et al 7 and Tambey et al 8 also showed that duration of analgesia provided by caudal Ropivacaine and Bupivacaine were similar. However studies by Locatell et al 9 , Soujanya et al 10 , and Sharma et al 11 showed significant longer duration of analgesia in Bupivacaine group.…”

Section: Discussionmentioning

confidence: 88%

Comparison of single shot caudal Ropivacaine and Bupivacaine in paediatric patients undergoing herniotomy

et al. 2019

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Background: Inguinal hernia repair is a common surgical procedure in children. Caudal block is an appropriate technique for the treatment of post operative pain in children undergoing herniotomy. This study compared the effects of Ropivacaine and Bupivacaine in caudal block in children undergoing herniotomy. Methodology: A total of 74 patients between 5-16 yrs undergoing herniotomy were randomized in two groups. In Group B, 0.75ml/kg of 0.25% caudal Bupivacaine was administered whereas Group R received 0.75 ml/kg of 0.25% caudal Ropivacaine. Pain score was assessed using Wong Baker pain scale in post operative period and motor power was assessed using modified Bromage scale till 6 hours. Results: The mean duration of post operative analgesia was found to be 253.51 ± 11.48 minutes in Bupivacaine and 258.1 ± 12.10 minutes in Ropivacaine group. The median duration of motor block was 180 (Q1 60- Q3 180) minutes in Bupivacaine and 30 (Q1 22.5- Q3 45) minutes in Ropivacaine group which was statistically significant. There was complete recovery of motor block by 2 hour in Ropivacaine and by 4 hour in Bupivacaine group. (p value< 0.001). Conclusion: From the current study, it is concluded that caudal Ropivacaine at 0.25% concentration and 0.75ml/ kg provides similar duration of post operative analgesia with less motor block in comparison to Bupivacaine.

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“…In another study, comparing analgesia after brachial plexus block using levobupivacaine and ropivacaine, there was also no difference between the groups with respect to postoperative analgesia 17 . Another study found no difference in pain control using 0.25% levobupivacaine, 0.25% ropivacaine and 0.25% bupivacaine 18 .…”

Section: Discussionmentioning

confidence: 96%

Impact of Pectoralis Nerve Block (PECS) on postoperative pain in patients submitted to mastectomy with lymphadenectomy

Leite

Rocha

OLIVEIRA

et al. 2022

Rev. Col. Bras. Cir.

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Objective: Breast cancer is the most common malignant neoplasm in women worldwide. Surgery has been traditional treatment and, generally, it´s mastectomy with lymphadenectomy, that can causes postoperative pain. Therefore, we seek to study regional anesthesic techniques that can minimize this effect, such as the interpectoral block (PECS). Methods: randomized controlled study with 82 patients with breast cancer who underwent mastectomy with lymphadenectomy from January 2020 to October 2021 in oncology hospital. Interventions: two randomized groups (control - exclusive general anesthesia and PECS group - received PECS block with levobupivacaine/ropivacaine and general anesthesia). We applied a questionnaire with Numeric Rating Scale for pain 24h after surgery. We used Shapiro-Wilk, Mann-Whitney and Chi-square tests, and analyzed the data in R version 4.0.0 (ReBEC). Results: in the PECS group, 50% were pain-free 24h after surgery and in the control group it was 42.86%. The majority who presented pain classified it as mild pain (VAS from 1 to 3) - (42.50%) PECS group and (40.48%) control group (p=0.28). Only 17.50% consumed opioids in the PECS group, similar to the control group with 21.43%. (p=0.65). There was a low rate of complications such as PONV in both groups. In the subgroup analysis, there was no statistical difference between the groups that used levobupivacaine or ropivacaine regarding postoperative pain and opioid consumption. Discussion: the studied group had a low rate of pain in the postoperative period and it influenced the statistical analysis. There wasn´t difference in postoperative pain in groups. Conclusion: was not possible to demonstrate better results with the association of the PECS block with total intravenous analgesia. Need further studies to assess the efficacy of the nerve block.

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A Comparative Study of 0.25% Levobupivacaine, 0.25% Ropivacaine, and 0.25% Bupivacaine in Paediatric Single Shot Caudal Block

Cited by 4 publications

References 15 publications

4. Comparison of the Postoperative Analgesic Effects of Levobupivacaine Wound Instillation with a Placebo after Unilateral Inguinal Hernia Repair: a Randomized-controlled Trial

4. Comparison of the Postoperative Analgesic Effects of Levobupivacaine Wound Instillation with a Placebo after Unilateral Inguinal Hernia Repair: a Randomized-controlled Trial

Comparison of single shot caudal Ropivacaine and Bupivacaine in paediatric patients undergoing herniotomy

Impact of Pectoralis Nerve Block (PECS) on postoperative pain in patients submitted to mastectomy with lymphadenectomy

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