A Comparison of Three Different Volumes of Levobupivacaine for Caudal Block in Children Undergoing Orchidopexy and Inguinal Hernia Repair

Objective: The aim of this study was to compare the efficacy of three different volumes of 0.25% levobupivacaine caudally administered on the effect of intra- and post-operative analgesia in children undergoing orchidopexy and inguinal hernia repair. Subjects and Methods: Forty children, aged 1 to 7 years, American Society of Anesthesiologists (ASA) physical status I and II, were randomized into 3 different groups according to the applied volumes of 0.25% levobupivacaine: group 1 (n=13): 0.6 ml.kg-1; group 2 (n=10): 0.8 ml.kg-1 and group 3 (n=17): 1.0 ml.kg-1. The age, weight, duration of anesthesia, onset time of intraoperative analgesic, dosage and addition of intraoperative fentanyl were compared among the groups. The time to first use of the analgesic as well as a number of patients who required analgesic 24 hours after surgery in the time intervals: within 6 hours, between 6-12 and between 12-24 hours postoperatively, were evaluated among the groups. Statistical analyses were performed with Dunett t-test, ANOVA or Kruskal Wallis test and Χ2 test. Logistic regression analysis was used in order to examine predictive factors on duration of postoperative analgesia. Results: The age, weight, duration of anesthesia, onset time of intraoperative analgesic, dosage and addition of intraoperative fentanyl was similar among the groups. The time to first analgesic use was similar among the groups and logistic regression model showed that the using the three different volumes of levobupivacaine had no predictive influence on duration of postoperative analgesia. The number of patients who required analgesic within 6 (3/2/3), between 6-12 (3/1/3) and between 12-24 hours (1/0/2) after surgery was similar among the groups. Conclusion: The three different volumes of 0.25% levobupivacaine provided the same quality of intra- and post-operative pain relief in pediatric patients undergoing orchidopexy and inguinal hernia repair.


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