A Comparison of Three Different Volumes of Levobupivacaine for Caudal Block in Children Undergoing Orchidopexy and Inguinal Hernia Repair

• Published in: Medical principles and practice 2017-01, Vol.26 (4), p.331-336
• Main Authors: Marjanovic, Vesna, Budic, Ivana, Stevic, Marija, Simic, Dusica
• Format: Article
• Language: English
• Subjects: Adjuvants, Anesthesia - administration & dosage; Analgesics; Analysis of Variance; Anesthesia; Anesthesia, Caudal; Anesthetics, Local - administration & dosage; Bupivacaine - administration & dosage; Bupivacaine - analogs & derivatives; Child; Child, Preschool; Children & youth; Drug dosages; Fentanyl - administration & dosage; Heart rate; Hernia, Inguinal - surgery; Hernias; Humans; Infant; Intensive care; Kruskal-Wallis test; Male; Orchiopexy - methods; Original Paper; Pain; Pain Measurement; Pain, Postoperative - drug therapy; Pediatrics; Physiology; Surgery; Treatment Outcome
• ISSN: 1011-7571; 1423-0151
• DOI: 10.1159/000475936

Objective: The aim of this study was to compare the efficacy of 3 different volumes of 0.25% levobupivacaine caudally administered on the effect of intra- and postoperative analgesia in children undergoing orchidopexy and inguinal hernia repair. Subjects and Methods: Forty children, aged 1-7 years, American Society of Anesthesiologists (ASA) physical status I and II, were randomized into 3 different groups according to the applied volumes of 0.25% levobupivacaine: group 1 (n = 13): 0.6 mL∙kg -1 ; group 2 (n = 10): 0.8 mL∙kg -1 ; and group 3 (n = 17): 1.0 mL∙kg -1 . The age, weight, duration of anesthesia, onset time of intraoperative analgesic, dosage, and addition of intraoperative fentanyl were compared among the groups. The time to first use of the analgesic and the number of patients who required analgesic 24 h after surgery in the time intervals within 6 h, between 6 and 12 h, and between 12 and 24 h postoperatively were evaluated among the groups. Statistical analyses were performed with a Dunnett t test, ANOVA, or Kruskal-Wallis test and χ 2 test. Logistic regression analysis was used in order to examine predictive factors on duration of postoperative analgesia. Results: Age, weight, duration of anesthesia, onset time of intraoperative analgesic, dosage, and addition of intraoperative fentanyl were similar among the groups. The time to first analgesic use did not differ among the groups, and logistic regression modelling showed that using the 3 different volumes of levobupivacaine had no predictive influence on duration of postoperative analgesia. The numbers of patients who required analgesics within 6 h (3/2/3), between 6 and 12 h (3/1/3), and between 12 and 24 h (1/0/2) after surgery were similar among the groups. Conclusion: The 3 different volumes of 0.25% levobupivacaine provided the same quality of intra- and postoperative pain relief in pediatric patients undergoing orchidopexy and inguinal hernia repair.