Abstract

Caudal epidural anaesthesia is commonly used in pediatric patients undergoing lower abdominal surgery. The choice of local anesthetic plays a crucial role in determining the efficacy and safety of this technique. This study aimed to compare the effects of ropivacaine and bupivacaine for caudal epidural anaesthesia in children undergoing lower abdominal surgery. Methods: A prospective, randomized, double-blinded study was conducted on 100 children aged 1-10 years scheduled for lower abdominal surgery. The patients were randomly assigned to two groups: Group R (ropivacaine) and Group B (bupivacaine). Caudal epidural anaesthesia was administered using either 0.2% ropivacaine or 0.25% bupivacaine, based on the group assignment. The primary outcome measures included the onset and duration of sensory and motor block, hemodynamic stability, and adverse events. Secondary outcome measures included postoperative pain scores, rescue analgesia requirement, and overall satisfaction. Results: Both ropivacaine and bupivacaine groups exhibited comparable demographic characteristics. The onset of sensory and motor block was similar in both groups (p > 0.05). However, the duration of sensory and motor block was significantly longer in the ropivacaine group compared to the bupivacaine group (p < 0.001). Hemodynamic stability was similar between the two groups, and no significant adverse events were observed. Postoperative pain scores were significantly lower in the ropivacaine group compared to the bupivacaine group (p < 0.001). The ropivacaine group also required less rescue analgesia and showed higher overall satisfaction scores. Conclusions: Ropivacaine and bupivacaine are both effective and safe choices for caudal epidural anaesthesia in children undergoing lower abdominal surgery. However, ropivacaine demonstrated a longer duration of sensory and motor block, superior postoperative pain control, decreased rescue analgesia requirement, and higher overall satisfaction. Therefore, ropivacaine may be considered as a preferable option for caudal epidural anaesthesia in this patient population. Further research is warranted to explore the long-term effects and potential complications associated with ropivacaine use in pediatric patients

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