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The efficacy of caudal ropivacaine 1, 2 and 3 mg·ml −1 for postoperative analgesia in children

2002; Wiley; Volume: 12; Issue: 1 Linguagem: Inglês

10.1046/j.1460-9592.2002.00769.x

1460-9592

Adrian Bösenberg, Jackson Thomas, T. Lopez, Anna Lybeck, Karin Huizar, Lill‐Inger Larsson,

Cardiac, Anesthesia and Surgical Outcomes

Background : The aim of this double blind, randomized, comparative study was to assess the analgesic efficacy and incidence of motor block after caudal block using three different concentrations of ropivacaine, 1, 2 and 3 mg·ml –1 , in children 4–12‐year‐old. Methods : One hundred and ten children ASA I–II, scheduled for inguinal surgery, were included in the study. After induction of a standardized general anaesthetic technique, all patients received 1 ml·kg –1 of the ropivacaine solution for a caudal block and were assessed for 8 h after the injection. Results : The ropivacaine was well tolerated in all patients. Median time to treatment with analgesics was 3.3, 4.5 and 4.2 h in the 1, 2 and 3 mg·ml –1 groups, respectively. During the first 4 h, the pain scores for both a 6‐graded faces scale and a 4‐graded observer scale were higher in the 1 mg·ml –1 group than the 3 mg·ml –1 group. The median sensory block reached T12 in all groups 1 h after the caudal block. Thereafter, the speed of regression was correlated with the ropivacaine concentration. In the patients with a sensory block from T12 and above, the median time to treatment with analgesics was longer than in the children with a sensory block below T12. The incidence of motor block was 28% in the 3 mg·ml –1 group in comparison with 0 and 13% in the 1 and 2 mg·ml –1 groups. Conclusions : It was concluded that 1 ml·kg –1 of ropivacaine 2 mg·ml –1 for caudal block provided satisfactory postoperative pain relief after inguinal surgery in 4–12‐year‐old children. Ropivacaine 1 mg·ml –1 showed less efficacy while the use of ropivacaine 3 mg·ml –1 was associated with a higher incidence of motor block with minimal improvement in postoperative pain relief.