A Comparison of Three Different Concentrations of Levobupivacaine for Caudal Block in Children

Ivani, Giorgio; Negri, Pasquale De; Lönnqvist, Per Arne; Eksborg, Staffan; Mossetti, Valeria; Grossetti, R; Italiano, Simona; Rosso, Franca; Tonetti, F; Codipietro, Luigi

doi:10.1213/01.ane.0000068881.01031.09

Cited by 61 publications

(43 citation statements)

References 17 publications

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“…In previous studies, bupivacaine produced a significant incidence of residual motor block after caudal block compared with levobupivacaine or ropivacaine [14,21]. Also, we did not observe residual motor blockade neither in group levobupivacaine-morphine nor in group levobupivacaine in our study.…”

Section: Discussioncontrasting

confidence: 58%

“…We used levobupivacaine 0.25% with bolus epidural injection or 0.125% levobupivacaine-morphine combination and total volume was limited 0.7 ml/kg. Ivani et al [14] investigated three different concentration levobupivacaine (0.125%, 0.20% and 0.25% in each group) for caudal blockade in a undergoing subumbilical surgery. They found that the use of 0.125% levobupivacaine for caudal blockade in children was associated shorter duration of postoperative analgesia compared to 0.20% and 0.25% concentration.…”

Section: Discussionmentioning

confidence: 99%

“…Taylor R., and colleagues [15] assessed the efficacy of 0.25% levobupivacaine (0.8 ml/kg) injected caudally in young children having penile or groin surgery. They reported that adequate intraoperative analgesia in 90% and a mean time to first postoperative analgesia of 7.3 h. Ivani G., et al [14] recruited sixty children aged 1-7 years of age having caudal blockade (1 ml/kg of ropivacaine 0.2%, levobupivacaine 0.25% or bupivacaine 0.25%) for either peno-scrotal or groin surgery. They reported that all blocks were successful with a similar time to onset (assessed by pin-prick) in all children and there were no differences in the number of children requiring supplemental analgesia or time to first postoperative dose.…”

Section: Discussionmentioning

confidence: 99%

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Epidural levobupivacaine versus levobupivacaine-morphine in postoperative analgesia for paediatric patients

Önal¹,

Hatipoğlu²,

Özcengiz³

et al. 2012

J Anesthesiol Clin Sci

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Background: We compared the effects of epidural levobupivacaine and levobupivacaine plus morphine administration on postoperative analgesia in children undergoing major abdominal surgery. Methods: After the approval by our Faculty Ethic Committee and informed consent of parents were taken, 47 children, aged between 1-14 year, undergoing major abdominal surgery were included. Following the anesthesia induction, an epidural catheter (22-24 G) was inserted by using Tuohy needle (19-20 G). Patients were randomly divided iiinto two groups. Epidural block was performed with levobupivacaine (0.125%) plus morphine (30µg/kg) in group I patients, and sole levobupivacaine (0.25%) in group II patients. Peroperative sevoflurane concentration, systolic and diastolic blood pressure and heart rate were recorded. Pain and sedation scores were recorded postoperatively. Side effects and the number of patients who required rescue analgesics were noted. Results: Sevoflurane concentrations were lower in group I patients than in group II patients at 10th and 30th minutes intraoperatively. In the first postoperative day, the number of the patients who required rescue analgesic was 7 in group I and 18 in group II (p=0.003). The duration of postoperative analgesia was longer in group I patients than group II patients (p=0.002). Pain and sedation scores were lower in group I patients than group II patients (p<0.05). No patient experienced hypotension, bradycardia or respiratory depression. Conclusion: We concluded that, epidural levobupivacaine plus morphine combination reduced intraoperative anesthetic concentration, supplied longer postoperative analgesia and required less rescue postoperative analgesic than sole levobupivacine, but it caused higher sedation.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Epidural levobupivacaine versus levobupivacaine-morphine in postoperative analgesia for paediatric patients

Önal¹,

Hatipoğlu²,

Özcengiz³

et al. 2012

J Anesthesiol Clin Sci

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“…The latter contains the latest spinal roots forming the cauda equina and the filum terminal. Levobupivacaine is widely used clinically in caudal and spinal anesthesia [2,4] to manage acute and chronic pain. It acts on pain by inhibiting the activity of NMDA receptors (N Methyl D Aspartate) in the dorsal horn of the spinal cord [16].…”

Section: Discussion Limitation Of the Studymentioning

confidence: 99%

Caudal Anesthesia: Experience in the Post-Operative Analgesia in Pediatric Ambulatory Surgery at the University Hospital of Treichville

Ango¹,

Kohou²,

Koné³

et al. 2017

OJAnes

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Introduction: The caudal anesthesia is used by many authors for postoperative analgesia. The purpose of this study was to report our experience in the practice of caudal block as post operative analgesia method in ambulatory surgery in a context of limited technical equipment. Patients and Method: Over a period of 5 months, a prospective study was conducted on 39 children aged 3 to 5 years weighing on average 15.12 kg. Children classified ASA I and II were selected. After premedication with midazolam (0.3 mg/kg) by intra rectal route, the inhalation induction was made with sevoflurane 8%, conveyed by fresh gas (50% O 2 and 50% air). The caudal block was obtained with the levobupivacaine 0.25% at a dose of 1 ml/kg. The hemodynamic parameters (systolic and diastolic blood pressure, heart rates) and respiratory parameters (respiratory frequency) pre-, per-and post-operative were measured. Postoperative pain was assessed with the Objective Pain Scale (OPS). The date of first use of analgesia was noted. The adverse effects of caudal block (meningitis, respiratory disorders, acute urinary retention, cardiac disorders) have been assessed. Results: The average duration of the procedure was 55.2 minutes. The use of analgesia was made 4 hours after skin closure, when the OPS Broadmann score was greater than 3. An agitation was observed in 6 children. Haemodynamic parameters have not significantly varied from the pre-to the post-operative. No infectious complications or intolerance to local anesthetics were observed. Allthe children were able to drink 4 hours after the end of the Conclusion: This type of anesthesia has been found very suitable for ambulatory surgery of the child, and is always helpful. It assured a post operative analgesia of good quality, and a reduction in consumption of morphine intraoperatively.

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“…Ivani et al had studied three different concentration of caudal levobupivacaine 1 ml/kg (0.125%, 0.2%, and 0.25%) without additives in children and they found that 0.125% concentration was associated with significantly less motor blockade than that with other concentration but also had significantly shorter duration of postoperative analgesia than that with levobupivacaine 0.2% or 0.25% [21] so if levobupivacaine is used without additives, it should be used in high concentration to ensure good quality of postoperative analgesia.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Caudal Ketamine with Different Concentrations of Levobupivacaine for Postoperative Analgesia in Paediatric Subumblical Surgeries

Mogahed¹,

Salama²

2017

J Anesth Clin Res

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A Comparison of Three Different Concentrations of Levobupivacaine for Caudal Block in Children

Abstract: The use of 0.125% levobupivacaine for caudal blockade (1 mL/kg) in children (1-7 yr) was associated with less early postoperative motor blockade but a shorter duration of postoperative analgesia compared with 0.20% and 0.25% solutions.

Cited by 61 publications

References 17 publications

Epidural levobupivacaine versus levobupivacaine-morphine in postoperative analgesia for paediatric patients

Epidural levobupivacaine versus levobupivacaine-morphine in postoperative analgesia for paediatric patients

Caudal Anesthesia: Experience in the Post-Operative Analgesia in Pediatric Ambulatory Surgery at the University Hospital of Treichville

Efficacy of Caudal Ketamine with Different Concentrations of Levobupivacaine for Postoperative Analgesia in Paediatric Subumblical Surgeries

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