BACKGROUND: Caudal epidural anesthesia is commonly performed in conjunction with general anesthesia. Bupivacaine and Levobupivacaine are used in epidural blockade that provide anesthesia and analgesia intraoperative and post-operatively.

OBJECTIVES: To compare the intraoperative and postoperative efficacy and safety of Bupivacaine and Levobupivacaine in children undergoing elective sub-umbilical operations under general and caudal anesthesia.

METHODS: Randomized control trial done in Philippine Children's Medical Center. Sixty-one subjects aged 6-months -8 years old, ASA I-II, undergoing subumbilical operations were randomly grouped to receive Bupivacaine and Levobupivacaine during anesthesia induction. Hemodynamic parameters, Bromage, and CHIPPS were recorded.

RESULTS: Results suggest both drugs have a significant effect in lowering heart rate and MAP. Bromage scores for patients from both groups are consistent at 0. The number of patients with a CHIPPS classification of 4-10, is significantly higher for bupivacaine group than levobupivacaine group.

CONCLUSION: Both Bupivacaine and Levobupivacaine provide adequate analgesia intraoperatively with no reports of intraoperative movement, increased inhalational agent concentration and additional intravenous analgesics. Post-operatively, no adverse effects and motor block was noted however Levobupivacaine has a longer efficacy as it required lesser rescue does post-operatively compared to Bupivacaine. 

Human ; Anesthesia, Caudal ; Bupivacaine ; Levobupivacaine ; Monitoring, Intraoperative

OBJECTIVE: To determine the efficacy and safety of intravenous single dose lidocaine versus single dose propofol in controlling emergence agitation in children aged 2-6 years old for surgery under sevoflurane anesthesia in Philippine Children’s Medical Center. MATERIALS AND METHODS: This was a double-blind, randomized controlled trial of 64 children aged 2-6 years who had surgery under general anesthesia using sevoflurane. Patients were randomly assigned into 2 equal groups – the experimental (Lidocaine, L) group and the control (Propofol, P) group. Five (5) minutes prior to the discontinuation of sevoflurane, the patient assigned to the L group was given Lidocaine at 1.5 mg/kg IV while the patient assigned to the P group was given Propofol 1 mg/kg IV. Patients were monitored using Pediatric Anesthesia Emergence Delirium (PAED) and Face, Legs, Activity, Cry, and Consolability (FLACC) scales 5 minutes after giving the medication until discharge from the PACU. Data was collected using a data abstraction form. RESULTS: There were no statistically significant differences between the 2 groups in terms of emergence agitation (RR= 0.5, 95% CI [0.098, 2.54], pvalue= 0.672) and post- operative pain (RR:0.6, 95% CI [0.033, 1.91], pvalue = 0.426). No adverse events were observed in both groups. CONCLUSION Both Lidocaine and Propofol are effective in preventing emergence agitation.
propofol ; lidocaine