A Comparative Study Between Ropivacaine and Bupivacaine in Pediatric Caudal Block for Postoperative Analgesia
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Abstract
Background: Advancements in pediatric anesthesia and pain management have made pediatric surgery safer. Caudal epidural analgesia is a common postoperative technique in children, offering benefits over general anesthesia alone. This study compared the analgesic efficacy of caudal 0.25% bupivacaine and 0.25% ropivacaine for postoperative pain management in infra-umbilical pediatric surgeries. Methods: A prospective, randomized study was conducted on 60 ASA I-II children (3-6 years) undergoing elective infraumbilical surgery at Sardar Vallabhbhai Patel Post Graduate Institute of Paediatrics (SVPPGI), Cuttack (2023-2024). Patients received either 0.75mg/kg of caudal 0.25% bupivacaine (Group B) or ropivacaine (Group R). Postoperative pain (Hannallah scale), time to first rescue analgesic, total analgesic consumption, motor blockade duration (Bromage), hemodynamics, SpO2, and adverse effects were recorded and analyzed. Results: Both groups were comparable. The ropivacaine group experienced significantly longer postoperative analgesia and a shorter duration of motor blockade compared to the bupivacaine group. Sensory recovery time and hemodynamic stability were similar between groups. No significant differences in side effects or dropouts were observed. Conclusion: Caudal 0.25% ropivacaine provides significantly longer postoperative analgesia and faster motor recovery than 0.25% bupivacaine in pediatric patients. Ropivacaine is an equipotent analgesic with reduced motor blockade, potentially enabling earlier ambulation and serving as a safe and effective alternative for pediatric caudal postoperative pain management.
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Copyright (c) 2025 Hemanta Kumar Das, Satyajit Behera, Jyotiranjan Mohapatra, Laxmidhar Dash
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