COMPARISON OF EFFICACY BETWEEN 0.25% BUPIVACAINE AND 0.25% LEVOBUPIVACAINE FOR CAUDAL ANESTHESIA IN PEDIATRIC INFRAUMBILICAL SURGERIES

In Anaesthesia, provision of pain relief is an essential part. One of the most popular regional blocks in children with higher success rate is caudal block for surgeries below the level of umbilicus. It is a useful adjunct technique during general  anesthesia and for providing post of analgesia for infra umbilical operations. This technique is  easier to perform and reduces the requirement of inhaled and intravenous anesthetic agent. It also attenuates the stress response to surgery, facilitates rapid and smooth recovery and provides reliable analgesia in the immediate post operative period. The quality and level of caudal block is dependent on the dose, volume and concentration of the drug injected. Bupivacaine is long-acting amide local anesthetic that has provided reliable anesthesia and analgesia with differential motor sensory blockade for more than 40years. Cardio toxicity and incidents of prolonged motor blockade urged the need for the development of a drug with wider margin of safety and similar clinical efficacy. So, S-enantiomers of bupivacaine were isolated and synthesized. One of the pure S-enantiomer of bupivacaine is levobupivacaine. It is claimed to have a wider margin of safety like less cardio toxicity and less post operative motor blockade.