Comparison of ropivacaine 0.1% and 0.2% with bupivacaine 0.2% for single‐shot caudal anaesthesia in children

We compared analgesic efficacy and degree of motor block induced by ropivacaine 0.1% (R 0.1) and 0.2% (R 0.2) vs. bupivacaine 0.2% (B 0.2) after caudal anaesthesia in children. Total and free plasma concentrations were measured after caudal injection. Duration of caudal analgesia (median/range) was significantly shorter in group R 0.1 (1.7 h/0.2–6 h) than in group R 0.2 (4.5 h/1.7–6 h) or group B 0.2 (4 h/1–6 h) ( P < 0.05). Motor block in the first 2 h postoperatively was significantly less for both ropivacaine groups compared with bupivacaine ( P < 0.05). Peak plasma concentrations after ropivacaine 0.2% were higher and protein binding lower than after bupivacaine 0.2% ( P < 0.05). We conclude that caudal analgesia with ropivacaine 0.1% is less effective and of shorter duration than that of ropivacaine 0.2%, whereas ropivacaine 0.2% provides pain relief similar to bupivacaine 0.2%. Motor block in the early postoperative period is less with ropivacaine than with bupivacaine.