A Comparison of Levobupivacaine and Bupivacaine in Caudal Anesthesia in Children Undergoing Sub-Umbilical Operation

Richard Andre  A. Lucero,; Marichu  D. Battad,; Teresita  A. Batanes,

A Comparison of Levobupivacaine and Bupivacaine in Caudal Anesthesia in Children Undergoing Sub-Umbilical Operation

Richard Andre A. Lucero | Teresita A Batanes | Marichu D. Battad

Abstract:

BACKGROUND: Caudal epidural anesthesia is commonly performed in conjunction with general anesthesia. Bupivacaine and Levobupivacaine are used in epidural blockade that provide anesthesia and analgesia intraoperative and post-operatively. OBJECTIVES: To compare the intraoperative and postoperative efficacy and safety of Bupivacaine and Levobupivacaine in children undergoing elective sub-umbilical operations under general and caudal anesthesia. METHODS: Randomized control trial done in Philippine Children’s Medical Center. Sixty-one subjects aged 6 months - 8 years old, ASA I-II, undergoing subumbilical operations were randomly grouped to receive Bupivacaine and Levobupivacaine during anesthesia induction. Hemodynamic parameters, Bromage, and CHIPPS were recorded. RESULTS: Results suggest both drugs have a significant effect in lowering heart rate and MAP. Bromage scores for patients from both groups are constant at 0. The number of patients with a CHIPPS classification of 4-10, is significantly higher for bupivacaine group than levobupivacaine group. CONCLUSION: Both Bupivacaine and Levobupivacaine provide adequate analgesia intraoperatively with no reports of intraoperative movement, increased inhalational agent concentration and additional intravenous analgesics. Post-operatively, no adverse effects and motor block was noted however Levobupivacaine has a longer efficacy as it required lesser rescue doses post-operatively compared to Bupivacaine.

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