A prospective study comparing the analgesic efficacy of levobupivacaine, ropivacaine and bupivacaine in pediatric patients undergoing caudal blockade

Breschan, Christian; Jost, Robert; Krumpholz, R.; Schaumberger, Florian; Stettner, Haro; Marhofer, Peter; Likar, Rudolf

doi:10.1111/j.1460-9592.2004.01443.x

Cited by 77 publications

(65 citation statements)

References 31 publications

(43 reference statements)

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“…Caudal bupivacaine, levobupivacaine and ropivacaine, produced similar times to onset of block and quality of postoperative analgesia (Breschan et al, 2005 Level II; Ivani et al, 2005 Level II; Frawley et al, 2006 Level II;Ingelmo et al, 2006 Level II). Concentration-dependent differences have been noted; ropivacaine 0.175% was superior to lower concentrations, and was as effective as a 0.2% solution but produced less motor block (Khalil et al, 2006 Level II).…”

Section: Caudal Analgesiamentioning

confidence: 89%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Caudal Analgesiamentioning

confidence: 89%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…When compared to Bupivacaine, Ropivacaine has a wide margin of safety, less motor blockade, 3,4 less cardiovascular or neurological toxicity 5 but has same duration of action. It can be used safely for regional anesthesia and analgesia in pediatrics.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Caudal Ropivacaine With Caudal Ropivacaine and Dexmedetomidine in Pediatric Lower Abdominal S U Rgeries

Gandhi¹,

Ved²,

Rajakumari³

2014

jemds

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PURPOSE:The objectives of this study were to compare the effects of caudal dexmedetomidine combined with Ropivacaine to provide postoperative analgesia in children and also to establish its safety in the pediatric patients. METHODS: In a randomized, prospective, parallel group, double-blinded study, 80 children of 1 year to 6years posted for lower abdominal surgeries were recruited and allocated into two groups: Group RD (n=40) received 0.25% Ropivacaine 1 ml/kg with dexmedetomidine2 μg/kg, making the volume to 0.5 ml and Group R (n=40) received 0.25% Ropivacaine1 ml/kg + 0.5 ml normal saline. Induction of anesthesia was achieved with Inj. Ketamine 2mg/kg + Inj. Succinylcholine 2mg/kg. Intubated with appropriate-sized Endotracheal tube and caudal block was performed in all patients. Maintained with 66% nitrous oxide in Oxygen and isoflurane 0.2-0.4%.Post-operative pain assessed with FLACC score. RESULTS: The duration of postoperative analgesia recorded a mean of 339 minutes (5.6hrs ± 2.4 hrs.) in Group R compared with 884 minutes (14.7 hrs. ±5hrs) in Group RD, with a p value of <0.001. Group RD patients achieved a statistically significant higher FLACC score compared with Group RD patients. The peri-operative hemodynamics were stable among both the groups. CONCLUSION: Caudal dexmedetomidine (2 μg/kg) with 0.25%Ropivacaine (1 ml/kg) for pediatric lower abdominal surgeries provides significant postoperative pain relief and better quality of sleep and a prolonged duration of arousable sedation.

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“…We think that is because they used high dose of local anesthetic agents. They also concluded that motor blockade was significantly less after levobupivacaine and ropivacaine than after bupivacaine during the first 2 h postoperatively [19].…”

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 prospective study comparing the analgesic efficacy of levobupivacaine, ropivacaine and bupivacaine in pediatric patients undergoing caudal blockade

Abstract: The degree of motor block was significantly less after ropivacaine and levobupivacaine during the first 2 h postoperatively.

Cited by 77 publications

References 31 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Comparative Study of Caudal Ropivacaine With Caudal Ropivacaine and Dexmedetomidine in Pediatric Lower Abdominal S U Rgeries

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

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