19942
document
Randomized , double-blind , phase III , controlled trial comparing levobupivacaine 0.25 % , ropivacaine 0.25 % and bupivacaine 0.25 % by the caudal route in children . BACKGROUND The rationale for replacing racemic bupivacaine with the s-enantiomers levobupivacaine and ropivacaine is to provide a wider margin of safety with the same analgesic efficacy and less postoperative motor block . In a randomized , double-blind , phase III , controlled trial we compared the caudal administration of levobupivacaine 0.25 % and ropivacaine 0.25 % with bupivacaine 0.25 % in children . METHODS Ninety-nine ASA I-II children less than 10 yr old scheduled for elective sub-umbilical surgery were randomized to receive caudal block with bupivacaine 0.25 % , ropivacaine 0.25 % or levobupivacaine 0.25 % . The primary outcome of the study was the clinical efficacy of the caudal block during the operation . Secondary outcome measures were analgesic onset time , pain relief after the operation and residual motor blockade . RESULTS The proportion of children with effective analgesia during the operation was similar among groups . There were no significant differences in the analgesic onset time of the caudal block . Bupivacaine produced a significant incidence of residual motor block compared with levobupivacaine or ropivacaine at wake-up ( P < 0.01 ) . There were no significant differences in the number of patients receiving rescue analgesia after surgery . However , analgesic block lasted significantly longer in patients receiving bupivacaine ( P=0.03 ) . CONCLUSION During sub-umbilical surgery , caudal levobupivacaine , ropivacaine and bupivacaine provided comparable analgesic efficacy . Bupivacaine produced a higher incidence of residual motor blockade and a longer analgesic block than ropivacaine and levobupivacaine .
19943
Intervention_Pharmacological
levobupivacaine
19944
Intervention_Pharmacological
ropivacaine
19945
Intervention_Pharmacological
bupivacaine
19946
Intervention_Pharmacological
racemic bupivacaine
19947
Intervention_Pharmacological
s-enantiomers levobupivacaine
19948
Intervention_Pharmacological
ropivacaine
19949
Intervention_Pharmacological
levobupivacaine
19950
Intervention_Pharmacological
ropivacaine
19951
Intervention_Pharmacological
bupivacaine
19952
Intervention_Pharmacological
bupivacaine
19953
Intervention_Pharmacological
ropivacaine
19954
Intervention_Pharmacological
levobupivacaine
19955
Outcome_Other
analgesic efficacy
19956
Outcome_Physical
postoperative motor block .
19957
Outcome_Other
clinical efficacy of the caudal block during the operation
19958
Outcome_Other
analgesic onset time ,
19959
Outcome_Pain
pain relief after the operation
19960
Outcome_Physical
residual motor blockade
19961
Outcome_Physical
residual motor block
19962
Outcome_Other
analgesic efficacy
19963
Outcome_Physical
incidence of residual motor blockade
19964
Outcome_Physical
analgesic block
19965
Participant_Sample-size
Ninety-nine
19966
Participant_Age
less than 10
19967
Participant_Condition
sub-umbilical surgery