الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Caudal block is a common method used for intra and post-operative pain relief in pediatric urologic and lower abdominal surgeries. The use of caudal block has increased in pediatric anaesthesia due to its easy application, and low complication rate.
Ultrasonogram-guided caudal block has become popular tool among pediatric anaesthesiologists for promoting precision, safety measures of the technique, and lowering the complication rates.
Racemic Bupivacaine is the most popular and commonly used local anaesthetic agent for caudal blockade. It has been widely used and extensively studied over decades. Cardiotoxicity and incidence of prolonged motor blockade stimulated the need for a drug with a wider margin of safety and a similar clinical efficacy. Hence S – enantiomers of bupivacaine were isolated and synthesized. Levobupivacaine is the S-enantiomer of bupivacaine.
The aim of this work was to compare the duration of postoperative analgesia between 0.25% levobupivacaine and 0.25% Bupivacaine in caudal block in pediatrics undergoing inguinal hernia repair, also to compare motor blockade, requirement of rescue analgesia, hemodynamics and other side effects if any.
The present study was carried out at El-shatby Alexandria university hospital on 50 patients of either sex, age range 2 month - 6 years. Patients were of American Society of Anaesthesiologist’s (ASA) physical status I or II who were scheduled for elective elective primary inguinal hernia repair.
All patients were evaluated before surgery through medical history, taking complete clinical examination, evaluation of the airways, and routine laboratory tests. Upon arrival to operation room patients were connected with the standard monitors, which included; ECG, blood pressure measurement, and measurement of peripheral blood oxygen saturation. All patients who participated in this study were subjected to the same anaesthesia protocol and the following parameters will be recorded:
A-Demographic data:
This included age and sex.
B- Hemodynamic parameters:
This included heart rate, mean arterial blood pressure and respiratory rate.
C- Postoperative motor block:
This was assessed in the recovery room using Modified Bromage scale scoring system.
D- Postoperative pain:
This was assessed using FLACC pain scale scoring system.
E- Duration of analgesia:
This is defined as the duration between the end of surgery and the first demand for supplemental analgesia and total analgesic requirement was recorded, as postoperative pain score of >4 was managed with Paracetamol 15 mg/kg IV.