A Comparison of 0.25% Levobupivacaine vs 0.2% Ropivacaine in Paediatric Circumcision

Circumcision is very often performed in pediatric surgery. Regional techniques are more effective than non-steroid anti-inflammatory drugs, systemic opioids, and acetaminophen for postoperative analgesia in pediatric circumcision. Dorsal penile nerve block is a safe and effective method for postoperative analgesia. We compared the postoperative analgesic efficacy, need for systemic drugs, with 0.25 % LEVOBUPIVACAINE vs 0.2 % ROPIVACAINE, in elective circumcision cases. METHODS 100 boys aged 1 to 12, ASA PS I undergoing elective circumcision participated in this study. Group 1 (n= 50) received a DPNB using a 25 G needle, with 0.25 % levobupivacaine 0.5 ml/kg. Group 2 (n = 50) received DPNB using a 25 G needle with 0.2 %ropivacaine 0.5 ml/kg. Upon completion of the surgery, the children were observed in the recovery room for pain, sedation, and side effects (nausea, vomiting, agitation, penile hematoma, bleeding, motor block, urinary retention) for 30 minutes. They were observed and recorded for the parameters at 1, 3, 6, 8, 10, 12, 16, 20, 24 hours. RESULTS No significant differences existed between the groups with respect to age, weight, or duration of anesthesia. Patients of both groups had similar pain scores. No opioid was used in either group, intraoperatively. Age (years) 3.51.43 Weight (Kg) 15.34.48 Duration of surgery (minutes) 18.43.40 During the 24 hour period none of the patients required analgesics. There was no statistically significant difference for the analgesic demand between group1 and group 2.5 minute FLACC pain score of the groups are mean standard deviation 1.05 2.39, 1.35 1.73. CONCLUSION DPNB with levobupivacaine and ropivacaine provide similar pain scores and painfree postoperative periods. Both the drugs are effective for long-term postoperative analgesia after circumcision. Supplementary analgesic need is nil and hence this will be very effective in day care.