Comparative study of higher volume lower concentration and lower volume higher concentration levobupivacaine in paediatric caudal block for postoperative pain relief in infraumbilical day care surgeries: Randomized observer blinded study

One of the commonly used regional anaesthesia technique for postoperative pain relief in paediatric surgery is caudal block. By increasing the volume of local anaesthetics, a higher initial level of blockade might extend the analgesic duration. Our aim was to compare analgesic durations between higher volume lower concentration and lower volume higher concentration levobupivacaine administered to children undergoing infraumbilical day care surgery. Materials and Methods: After obtaining ethical clearance and informed consent from guardian we performed randomized, prospective, observer-blinded study. Sample size calculated was 24 in each group. Caudal block was performed after induction and securing airway with appropriate size LMA. Children aged 6months to 5yr ASA I-II, received Levobupivacaine either 0.8 mL/kg of 0.375% (lower volume/ higher concentration [Group L], n 24) or 1.5 mL/kg of 0.1% solution (higher volume/ lower concentration [Group H], n 24) with radioopaque dye. Duration of analgesia and time for the 1st dose of oral acetaminophen was noted. Results: Fluoroscopic examination showed the spread levels of Levobupivacaine to T12(T12–L2) in Group L and T6 (T4–T8) in Group H. The mean duration of analgesia in Group H was significant than in Group L, i.e., 639.091 ± 89.8628 min and 587.028 ± 87.7387 (P < 0> Conclusions: Caudal analgesia with higher volume lower concentration of levobupivacaine (0.1%) provides longer duration of analgesia than lower volume higher concentration levobupivacaine (0.375%) in children undergoing day-care infraumbilical surgery.