Comparison of a Combination of Caudal Levobupivacaine with Fentanyl and Levobupivacaine Alone for Alleviating Postoperative Pain During Infraumbilical Procedures in Children Under 3 Years

Background: To compare the post-operative analgesic efficacy of caudal blockade using levobupivacaine alone and a combination of fentanyl with levobupivacaine in children under 3 years undergoing infraumbilical surgeries. Combination of levobupivacaine with fentanyl and levobupivacaine alone in children for caudal block was never studied before. Hence there was a need for the study. Methods: After approval from Institutional Ethical Committee, Kasturba Medical College, Mangaluru, 60 patients of age group 0-3 years, either sex of ASA physical status 1 and 2 undergoing infraumbilical surgeries were chosen after written parental consent and were randomised into 2 groups of 30 each L and LF using computer generated block randomisation to receive caudal blocks. Post operatively assessed for pain using CHIPPS scale at 2, 4, 6, 12 and 24 hours and compared in both groups. Results: Out of 60 patients, 30 in each group [L and LF], CHIPPS scores at 2, 4, 6, 12 and 24 hours post-operatively exhibited a p-value of 0.545, 0.492, 0.626, 0.166, and 0.329 respectively [not significant]. Mean duration of analgesia was 14.60 in Group L & 17.67 in Group LF with a t test p value of 0.119 [not significant]. Conclusion: Combination of fentanyl with levobupivacaine when compared to levobupivacaine alone for caudal block was equianalgesic in children less than 3 years undergoing infra umbilical procedures.