A Comparative, Cross Sectional, Observational Study to Assess the Post Operative Analgesic Efficacy of Bupivacaine VS Levobupivacaine in Illioinguinal / Illiohypogastric Nerve Block for Paediatric Patients Undergoing Inguinal Surgeries
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 1
Abstract
Introduction: Bupivacaine is the most commonly used local anaesthetic pediatric regional blocks. Levobupivacaine, a pure S- enantiomer of bupivacaine, is a long acting local anaesthetic that has a safer pharmacological profile with less cardiac and neurotoxic adverse effects. The present study compared the quality, efficacy, duration of post operative analgesia and adverse effects with Levobupivacaine versus Bupivacaine when used in illioinguinal / illiohypogastric nerve block for pediatric patients undergoing inguinal surgeries. Material and Methods: A comparative, cross sectional, analytical and observational study was done using a convenient sampling method, 60 paediatric ASA I and II patients undergoing elective inguinal surgeries were divided into 2 groups of 30 each. In L group, illioinguinal / illiohypogastric nerve block was given with 0.25% Levobupivacaine while in B group, 0.25% Bupivacaine was used. In both the groups the total volume of the drug was kept at 0.4ml/kg and the total dose of drug was not more than 2mg/kg. Results: Patients in Levbupivacaine Group had clinically lower OPS scores and hence better analgesia throughout the observation period as well as significantly prolonged duration of analgesia than Bupivacaine group. The mean duration of analgesia with Bupivacaine was 230 ± 41.19 minutes while with Levobupivacaine it was 344 ± 62.9 minutes as assessed by Broadmans OPS score. All patients were haemodynamically stable during the postoperative period. There was no incidence of bradycardia, respiratory depression, convulsions, hypotension, nausea, vomiting and urinary retention in any patient from both the groups. Conclusion: Both Levobupivacaine and Bupivacaine provide safe and effective analgesia when given in illioinguinalilliohypogastric nerve block in pediatric patients for inguinal surgeries Levobupivacaine provides prolonged and better quality post operative analgesia as compared to bupivacaine. Illioinguinal and illiohypgastric nerve block is a simple, safe and easy to perform technique which is devoid of complications of central neuraxial blockade and ideal in day care settings.
Authors and Affiliations
Rashmi Agrawal, Charulata Deshpande
Keywords
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