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Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery

CONTEXT: Ropivacaine, s-enantiomer of amide local anaesthetic produces differential neural blockade with less motor blockade, cardiovascular and neurological toxicity makes it suitable for day case surgery in children. AIMS: To compare the effectiveness of Inj. Ropivacaine (0.2 or 0.25%) or Inj. Bup...

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Autores principales: Doctor, Tarlika P., Dalwadi, Divyang B., Abraham, Lissa, Shah, Namrata, Chadha, Indu A., Shah, Bharat J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173527/
https://www.ncbi.nlm.nih.gov/pubmed/25885835
http://dx.doi.org/10.4103/0259-1162.118965
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author Doctor, Tarlika P.
Dalwadi, Divyang B.
Abraham, Lissa
Shah, Namrata
Chadha, Indu A.
Shah, Bharat J.
author_facet Doctor, Tarlika P.
Dalwadi, Divyang B.
Abraham, Lissa
Shah, Namrata
Chadha, Indu A.
Shah, Bharat J.
author_sort Doctor, Tarlika P.
collection PubMed
description CONTEXT: Ropivacaine, s-enantiomer of amide local anaesthetic produces differential neural blockade with less motor blockade, cardiovascular and neurological toxicity makes it suitable for day case surgery in children. AIMS: To compare the effectiveness of Inj. Ropivacaine (0.2 or 0.25%) or Inj. Bupivacaine (0.25%) with fentanyl in caudal block for intra and postoperative analgesia. SETTINGS AND DESIGN: Double blind retrospective randomized study. MATERIALS AND METHODS: All the patients (n=112) varying from age group 3.02 ± 3.29 years belonging to ASA I-IV were randomly allocated to receive caudal analgesia Group BF inj. Bupivacaine (0.25%, 2 mg/kg) + Inj. Fentany1 μg/kg (n=70) and group RF: Inj. Ropivacaine (0.25% or 0.2%, 2 mg/kg) + inj. Fentanyl 1 μg/kg (n=42). We monitored vitals and requirement of inhalational gases inraoperatively and also observed pain by pain score (Visual Analogue Score in verbal group and Objective Pain Scale in nonverbal group) and vitals postoperatively. We used rescue analgesics (inj. Paracetamol 5 mg/kg iv) when VAS score ≥4. STATISTICAL ANALYSIS: Student's t-test. RESULTS: Duration of analgesia was prolonged in both group RF and BF. Time for first rescue analgesic for group RF (6.1 ± 1.1 hr) compared to group BF (5.6 ± 0.9 hr). Haemodynamic stability and less requirement of inhalation agent intraoperatively with group RF than others. CONCLUSIONS: Ropivacaine with Fentanyl found to be better combination for pediatric surgeries for below umbilical surgeries as an adjuvant to general anaesthesia or sole technique with chances of less complication with high success rate.
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spelling pubmed-41735272014-10-22 Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery Doctor, Tarlika P. Dalwadi, Divyang B. Abraham, Lissa Shah, Namrata Chadha, Indu A. Shah, Bharat J. Anesth Essays Res Original Article CONTEXT: Ropivacaine, s-enantiomer of amide local anaesthetic produces differential neural blockade with less motor blockade, cardiovascular and neurological toxicity makes it suitable for day case surgery in children. AIMS: To compare the effectiveness of Inj. Ropivacaine (0.2 or 0.25%) or Inj. Bupivacaine (0.25%) with fentanyl in caudal block for intra and postoperative analgesia. SETTINGS AND DESIGN: Double blind retrospective randomized study. MATERIALS AND METHODS: All the patients (n=112) varying from age group 3.02 ± 3.29 years belonging to ASA I-IV were randomly allocated to receive caudal analgesia Group BF inj. Bupivacaine (0.25%, 2 mg/kg) + Inj. Fentany1 μg/kg (n=70) and group RF: Inj. Ropivacaine (0.25% or 0.2%, 2 mg/kg) + inj. Fentanyl 1 μg/kg (n=42). We monitored vitals and requirement of inhalational gases inraoperatively and also observed pain by pain score (Visual Analogue Score in verbal group and Objective Pain Scale in nonverbal group) and vitals postoperatively. We used rescue analgesics (inj. Paracetamol 5 mg/kg iv) when VAS score ≥4. STATISTICAL ANALYSIS: Student's t-test. RESULTS: Duration of analgesia was prolonged in both group RF and BF. Time for first rescue analgesic for group RF (6.1 ± 1.1 hr) compared to group BF (5.6 ± 0.9 hr). Haemodynamic stability and less requirement of inhalation agent intraoperatively with group RF than others. CONCLUSIONS: Ropivacaine with Fentanyl found to be better combination for pediatric surgeries for below umbilical surgeries as an adjuvant to general anaesthesia or sole technique with chances of less complication with high success rate. Medknow Publications & Media Pvt Ltd 2013 /pmc/articles/PMC4173527/ /pubmed/25885835 http://dx.doi.org/10.4103/0259-1162.118965 Text en Copyright: © Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Doctor, Tarlika P.
Dalwadi, Divyang B.
Abraham, Lissa
Shah, Namrata
Chadha, Indu A.
Shah, Bharat J.
Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery
title Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery
title_full Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery
title_fullStr Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery
title_full_unstemmed Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery
title_short Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery
title_sort comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173527/
https://www.ncbi.nlm.nih.gov/pubmed/25885835
http://dx.doi.org/10.4103/0259-1162.118965
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