Comparison of caudal ropivacaine 0.2% with bupivacaine 0.2% in pediatric patients – a randomized controlled trial

Abstract

Aim: The aim of our study was to compare the efficacy and duration of analgesia of caudally administered
0.2% ropivacaine with 0.2% bupivacaine along with recovery of motor and sensory blockade in pediatric
patients undergoing infraumbilical surgery.
Methodology: In this prospective, double blind study, 60 pediatric patients planned for infraumblical
surgery, of ASA grade I or II, were randomly allocated in two different groups to receive 1 ml/kg of either
0.2% ropivacaine (Group A) or 0.2% bupivacaine (Group B) via caudal route after induction of general
anesthesia. Objective pain score (OPS) and total duration of analgesia along with rescue analgesia were
compared in both the groups. Recovery of motor and sensory blockade was also noted. The results were
analyzed statistically using student’s paired t-test for intergroup comparison and chi square test for nonparametric
data or complications.
Result: Both the groups were comparable regarding age, weight, sex distribution and duration of
surgery. Patients remained hemodynamically stable during intraoperative period in both the groups.
The maximum mean sedation score at the beginning of the stay in the recovery room was 0.60 ± 0.67
and 0.67 ± 0.71 in Group A and B respectively. Though the OPS were marginally higher in Group B as
compared to Group A but the differences in total duration and quality of analgesia were not statistically
significant. Average duration of analgesia was 390.2 ± 35.16 min and 377.0 ± 34.41 min in Group A and
B respectively. However, motor recovery was faster in ropivacaine group with MPS of 10.00 ± 0.00 in
comparison to 8.80±0.99 in bupivacaine group (P value <0.01) at 2 hours in postoperative period.
Conclusion: Caudal ropivacaine 0.2% is equally effective local anesthetic agent when compared to
caudal bupivacaine 0.2% in terms of postoperative analgesia, but with faster motor recovery in pediatric
patients.