Comparative Evaluation Of Bupivacaine And Ropivacaine For Post operative Pain Management In Palatal Surgeries A Randomized Controlled Trial

Abstract

Aim newlineThe purpose of this study is to evaluate the effectiveness of two local anesthetic newlineagents, Bupivacaine and Ropivacaine in the management of postoperative pain newlinefollowing palatoplasty newlineMaterials and Methods newlineIn this prospective randomized triple blinded controlled single center study, 36 newlinechildren upto 6 years of age diagnosed with cleft palate were enrolled. The newlinepatients were divided equally (n=12) amongst three groups, Control group newline(Group A) received 2mg/kg body weight of 2% lignocaine hydrochloride, newlineBupivacaine group (Group B) received 2mg/kg body weight of 0.5% bupivacaine newlinehydrochloride and Ropivacaine group (Group C) received 2mg/kg body weight of newline0.75% ropivacaine hydrochloride as greater palatine and nasopalatine nerve newlineblocks. Patients received 15mg/kg body weight of rectal paracetamol newlinesuppository as rescue analgesia. Primary outcomes assessed were pain (FLACC newlinescores, VAS scores), sedation (sedation scores) and need for rescue analgesia newlineover the postoperative observation periods 1 hour, 2, 4, 6, 8, 12 and 24 hours. newlineThe data was analyzed using statistical package for windows [SPSS version 21, newlineArmonk, IBM Corp. USA]. Chi square test, One way ANOVA followed by post newlinehoc tukey tests, Kruskal Walis tests and Mann Whitney test was done between newlinethree groups. Results were considered significant if p-value and#8804; 0.05. newlineResults newlineUsing Mann Whitney test between the groups revealed that Ropivacaine group newlinehad the lowest pain scores when compared to Bupivacaine and control groups newlineat different time intervals (p=0.001). There was a significant difference in VAS newlinescores and FLACC scores among study participants after 1 hour, 2 hours, 4 newlinehours, 6 hours, 8 hours, 12 hours and 24 hours postoperatively (p=0.001). newline83.3% of study participants in ropivacaine group and 100% in control group newlinewere alert and awake at 6 hours postoperatively, which was statistically newlinesignificant (p=0.001). Both Ropivacine and Bupivacaine had longer mean time before first analgesia was taken post operatively than the control group. newline