Epidural Bupivacaine Research Articles

A COMPARISON OF DEXMEDETOMIDINE AND FENTANYL AS AN ADJUVANT TO 0.25% BUPIVACAINE FOR EPIDURAL ANALGESIA IN PERCUTANEOUS NEPHROLITHOTOMY (PCNL)

Background: PCNL can be performed under general anesthesia or regional anesthesia. PCNL is usually performed under general anesthesia due to better control of breathing and more comfort for the patients.
 Methods: The study was conducted on 75 patients devided in 3 groups (n=25 in each group) undergoing PCNL. After obtaining permission from Research review board and institutional ethics committee. Informed and written consent was obtained from all patients for performance of epidural anaesthesia after complete explanation about the study protocol, side effects related to the drugs and procedure to the patient.
 Results: The onset of sensory block was comparable in group B(7.28 ± 0.93min) and group C (6.88 ± 0.97min) , faster when compared to group A (8.16 ± 0.85min) group. The mean time of onset of motor block was comparable in group C (18.08 ± 1.41min) and group B (20.56 ± 1.61min) but slightly faster when compared to group A (26.08 ± 1.19min) group. The mean VAS score was lower in GroupC followed by GroupB and was highest in GroupA from 2hours to 5hours after surgery. Sedation score was significant higher in Group C (p<0.001) as compared to Group A and B and there was no significant difference between Group A and B.
 Conclusion: We conclude that PCNL can be performed using 0.25% bupivacaine in epidural anaesthesia without compromising on patient's comfort and surgeon's satisfaction.
 Keywords: Percutaneous nephrolithotomy (PCNL), Dexmedetomidine, Fentanyl, Bupivacaine

A prospective randomised double blind clinical study comparing ropivacaine and fentanyl with bupivacaine and fentanyl for labour epidural analgesia

A prospective randomised double blind clinical study comparing ropivacaine and fentanyl with bupivacaine and fentanyl for labour epidural analgesia - IJCA- Print ISSN No: - 2394-4781 Online ISSN No:- 2394-4994 Article DOI No:- 10.18231/2394-4994.2019.0016, Indian Journal of Clinical Anaesthesia-Indian J Clin Anaesth

Comparison of cost and outcomes in patients receiving thoracic epidural versus liposomal Bupivacaine for video-assisted thoracoscopic pulmonary resection

Comparison of cost and outcomes in patients receiving thoracic epidural versus liposomal Bupivacaine for video-assisted thoracoscopic pulmonary resection

A comparative study of caudal epidural bupivacaine with bupivacaine plus fentanyl and bupivacaine plus neostigmine for anaesthesia and postoperative analgesia in children undergoing sub-umbilical surgeries

Background: Single-shot caudal anaesthesia with local anaesthetic has a limited duration of action.Therefore, many children undergoing sub-umbilical surgery with caudal analgesia require furtheranalgesia during the postoperative period. This study compared the effect of single-dose caudal epiduralbupivacaine, bupivacaine plus fentanyl and bupivacaine plus neostigmine for anaesthesia andpostoperative analgesia in children. Objective: To evaluate effectiveness of bupivacaine with the addition of fentanyl or neostigmine forcaudal anaesthesia and analgesia in children undergoing sub-umbilical surgeries. Methods: Total ninety (90) paediatric patients, aged 2-8 years with ASA(American society ofanesthesiologist) grades I & II who were scheduled for surgery in Sher-E-Bangla Medical college Hospital,Barisal were included in this study. Data were collected by using a pre-designed questionnaire. Thepatients were randomly allocated to one of the three groups. Group A was received caudal 1 ml/kg ofbupivacaine 0.25%, Group B 1 ml/kg of bupivacaine 0.25% with fentanyl 1 μg/kg and Group C 1 ml/kgof bupivacaine 0.25% with neostigmine 2 μg/kg. Heart rate (HR), Blood pressure (BP), oxygen saturation(SpO2), Respiratory rate (RR) were recorded during operation and every five minutes thereafter. Theduration of analgesia was defined as the time from caudal injection to first dose of rescue analgesia.Rescue analgesia was given for an objective pain scale (greater than or equal to) 4 in the form of oralparacetamol (15mg/kg). Results: Assessment of anaesthesia was significantly longer in the two groups of children who receivedadditives compared with local anaesthetics group alone (p<0.01). Mean time to first postoperativeanalgesic administration was 167.37±17.30 min, 280.57±14.40min, and 357.77±19.08 min in groupA, Group B, and group C respectively. The difference was statistically significant (p<0.01) between thethree groups. In these cases duration of analgesia was considered from the placement of caudal to firstanalgesia. Conclusion: Addition of fentanyl or neostigmine to bupivacaine prolonged the duration of surgicalanaesthesia and postoperative analgesia after a single shot caudal injection with minimal incidence ofside effects in children undergoing sub-umbilical surgeries. This could be a safe and cheap alternative toextradural catheter placement for surgical procedures of intermediate duration. JBSA 2019; 32(1): 3-9

Comparison of Postoperative Analgesia Following Epidural Bupivacaine and Epidural Bupivacaine with Verapamil in Orthopaedic Lower Limb Surgeries

Comparison of Postoperative Analgesia Following Epidural Bupivacaine and Epidural Bupivacaine with Verapamil in Orthopaedic Lower Limb Surgeries

The effects of adding dexamethasone to epidural bupivacaine for lower limb orthopedic surgery

Introduction Dexamethasone when given epidurally with local anesthetics is known to reduce postoperative pain and postoperative analgesic consumption in several types of surgical procedures. Objective The objective of this study was to evaluate the effect of epidural dexamethasone on postoperative analgesia in patients who were undergoing lower limb orthopedic surgery. Patients and methods It is a prospective, randomized, double-blinded comparative study carried out in Assiut University Hospital, Egypt. It included 50 patients divided into two equal groups (25 in each), who underwent lower limb orthopedic surgery. The saline group: who received 15 ml epidural plain bupivacaine (0.5%)+2 ml normal saline (BS) and the dexamethasone group: who received 15 ml epidural plain bupivacaine (0.5%)+8 mg dexamethasone (2 ml) (BD). Postoperatively, when the pain score of at least 4, the rescue analgesia was given in the form of fentanyl and bupivacaine epidurally and paracetamol (perfalgan) 1 g was given routinely for all patients intravenous drip/8 h. Pain was evaluated by visual analog scale every 4 h in the postoperative 24 h. Time to first request for analgesia and total dose of rescue analgesia (epidural fentanyl/bupivacaine) in the first, 24 h postoperative was recorded. Results Dexamethasone significantly reduced the first, 24 h postoperative pain score (visual analog scale), and postoperative epidural fentanyl consumption (70.00 vs. 43.40 μg) in the first, 24 h postoperative. Dexamethasone also significantly prolonged the time to first request for analgesia (3.38 ± 0.072 vs. 15.24 ± 2.03 h). Conclusion Epidural dexamethasone with bupivacaine offers favorable effects on postoperative analgesia in lower limb orthopedic surgery.

Comparative study of dexmedetomidine or fentanyl as an adjuvant to epidural bupivacaine for prevention of stump and phantom pain in adult patients undergoing above-knee or below-knee amputation: a randomized prospective trial

Background Phantom-limb pain is one of the most difficult-to-treat chronic pain syndromes. In this randomized prospective trial, we studied the effect of administering fentanyl or dexmedetomidine as additive to bupivacaine in epidural catheter in perioperative period to reduce acute postoperative stump and phantom pain and opioid consumption in patients undergoing unilateral above- or below-knee amputation.Patients and methods Over 2 years, 62 patients with American Society of Anesthesiologists physical status I–II scheduled for unilateral knee amputation were analyzed. In this prospective study, two equal groups of patients randomly received dexmedetomidine or fentanyl as epidural infusion 24 h before operation and 72 h after surgery. Visual analog scale, sedation scale, patient satisfaction, incidence of phantom, and stump pain and cumulative opioid consumption over 3 days were used to compare the two groups.Results Incidence of postoperative stump and phantom pain in group D was less significantly in comparison with group F in the first 72 h postoperatively. Moreover, after 6 months, we found the same result. Patients’ satisfaction was significantly higher in group D in comparison with group F (P˂0.01). Visual analog scale was statistically significant lower in group D than group F in the 72-h postoperative period. This led to the more use of rescue analgesic (meperidine) in group F 232±23.1 mg than group D 142.2±46.68 mg. There was a statistically significant increase in preoperative sedation score in group D. Patients in group D experienced bradycardia and hypotension significantly more than group F. However, patients in group F experienced significantly from itching than group D.Conclusion Adding dexmedetomidine to bupivacaine as epidural infusion has been found to provide better postoperative analgesia, reduce opioid consumption, and decrease incidence of phantom and stump pain. It also improves patient satisfaction and decreases intensity of pain.

A study to evaluate the effect of Dexmedetomidine and Ketamine as adjuvant to epidural bupivacaine for postoperative analgesia in gynaecological surgeries

A study to evaluate the effect of Dexmedetomidine and Ketamine as adjuvant to epidural bupivacaine for postoperative analgesia in gynaecological surgeries

A Clinical Prospective, Randomized Study to Compare Combined Spinal Epidural Bupivacaine – Fentanyl and Ropivacaine – Fentanyl for Lower Abdominal and Pelvic Surgeries

A Clinical Prospective, Randomized Study to Compare Combined Spinal Epidural Bupivacaine – Fentanyl and Ropivacaine – Fentanyl for Lower Abdominal and Pelvic Surgeries

Preemptive analgesia for postoperative pain relief in thoracolumbosacral spine operations: a double-blind, placebo-controlled randomized trial.

OBJECTIVEPreemptive administration of analgesic medication is more effective than medication given after the onset of the painful stimulus. The efficacy of preoperative or preemptive pain relief after thoracolumbosacral spine surgery has not been well studied. The present study was a double-blind, placebo-controlled randomized trial of preemptive analgesia with a single-shot epidural injection in adult patients undergoing spine surgery.METHODSNinety-nine adult patients undergoing thoracolumbosacral operations via a posterior approach were randomized to receive a single shot of either epidural placebo (group 1), hydromorphone alone (group 2), or bupivacaine with hydromorphone (group 3) before surgery at the preoperative holding area. The primary outcome was the presence of opioid sparing and rescue time-defined as the time interval from when a patient was extubated to the time pain medication was first demanded during the postoperative period. Secondary outcomes include length of stay at the postanesthesia care unit (PACU), pain score at the PACU, opioid dose, and hospital length of stay.RESULTSOf the 99 patients, 32 were randomized to the epidural placebo group, 33 to the hydromorphone-alone group, and 34 to the bupivacaine with hydromorphone group. No significant difference was seen across the demographics and surgical complexities for all 3 groups. Compared to the control group, opioid sparing was significantly higher in group 2 (57.6% vs 15.6%, p = 0.0007) and group 3 (52.9% vs 15.6%, p = 0.0045) in the first demand of intravenous hydromorphone as a supplemental analgesic medication. Compared to placebo, the rescue time was significantly higher in group 2 (187 minutes vs 51.5 minutes, p = 0.0014) and group 3 (204.5 minutes vs 51. minutes, p = 0.0045). There were no significant differences in secondary outcomes.CONCLUSIONSThe authors' study demonstrated that preemptive analgesia in thoracolumbosacral surgeries can significantly reduce analgesia requirements in the immediate postoperative period as evidenced by reduced request for opioid medication in both analgesia study groups who received a preoperative analgesic epidural. Nonetheless, the lack of differences in pain score and opioid dose at the PACU brings into question the role of preemptive epidural opioids in spine surgery patients. Further work is necessary to investigate the long-term effectiveness of preemptive epidural opioids and their role in pain reduction and patient satisfaction.Clinical trial registration no.: NCT02968862 (clinicaltrials.gov).

Comparison of cost and outcomes in patients receiving thoracic epidural versus liposomal bupivacaine for video-assisted thoracoscopic pulmonary resection

BackgroundThoracic Epidural has long been the most recommended treatment for postoperative pain management in general thoracic surgery. This study compares liposomal bupivacaine (LB) as an alternative method for pain control and compares it to the standard. MethodsLB was compared to thoracic epidural bupivacaine hydrochloride (TE BH) in 387 patients who underwent video-assisted thoracoscopic pulmonary resection (VATS-R) at our institution. Patients received either continuous TE BH or intraoperative LB at a predetermined dose. A total of 237 patients received TE BH from April 2010 to March 2014 and 143 patients received LB from April 2014 to March 2016. After propensity matching, 95 patients in each group had similar demographics and clinical characteristics including gender, age, race, American Society of Anesthesia (ASA) classification, Zubrod scores, and FEV1 and DLCO percent predicted measurements. Outcome measures included hospital costs, length of stay (LOS), adverse events, postoperative opioid medication use, and pain scores. ResultsCompared to the TE BH group, the LB group had significantly lower pain scores (average visual analogue scale the day of surgery: 3.9 versus 4.5, p < 0.05), decreased postoperative opioid medication (morphine equivalent dose during the first 3 days: 344.5 versus 269.5, p < 0.05), and lower total and direct hospital costs ($2906 and $1865 respectively, p < 0.05). Although a shorter LOS in the LB group was not statistically significant (4.3 versus 5.1 days, p = 0.156), more patients in the LB group were discharged directly home than the control group (44.2% versus 28.4%, p < 0.05). There was no difference noted in overall adverse events including 30-day readmissions between the two groups. ConclusionLB is a viable alternative for pain management in patients undergoing VATS-R. With recent scrutiny on healthcare costs and the opioid epidemic, these results are encouraging and should be further investigated.

Epidural dexmedetomidine infusion for perioperative analgesia in patients undergoing abdominal cancer surgery: randomized trial

ObjectiveTo assess the postoperative analgesic efficacy of epidural dexmedetomidine added to bupivacaine infusion for patients undergoing major abdominal cancer surgery.MethodsPatients scheduled for major upper abdominal cancer surgery were allocated to group bupivacaine (n =32), in which patients received epidural bupivacaine infusion (6 mL/h bupivacaine 0.1%) for 48 hours postoperatively, or group bupivacaine + dexmedetomidine (n=32), in which patients received epidural dexmedetomidine added to bupivacaine infusion (6 mL/h of bupivacaine 0.1% + dexmedetomidine, 0.5 µg/mL) for 48 hours postoperatively. The cumulative morphine consumption, the time to first analgesic request, and the VAS pain score were evaluated.ResultsThe cumulative morphine consumption was significantly reduced in group bupivacaine + dexmedetomidine compared with group bupivacaine: mean ± SD of 10.40±5.16 mg vs 23.23±8.37 mg with an estimated difference (95% CI) of −12.83 (−16.43, −9.24), (P<0.001). The time to the first analgesic demand was significantly delayed in group bupivacaine + dexmedetomidine compared with group bupivacaine: median (IQR) of 6 (1.75, 8.25) h vs 1 (0, 4)h, (P<0.001). The mean collapsed over time of overall VAS pain scores at rest and movement was significantly reduced in group bupivacaine + dexmedetomidine compared with group bupivacaine : mean ± SE of 1.6±0.08 vs 2.38±0.08 with an estimated difference (95% CI) of −0.8 (−1, −0.86), (P<0.001), and mean ± SE of 2.17±0.07 vs 3.25±0.07 with an estimated difference (95% CI) of −1.1 (−1.27, – 0.89), (P<0.001), respectively.ConclusionEpidural infusion of dexmedetomidine added to bupivacaine for patients undergoing major abdominal cancer surgery significantly reduced morphine consumption, delayed time to first analgesic supplementation, and decreased pain intensity during the first 48 hours postoperatively without harmful derangement on hemodynamics.

Effect of Adding Magnesium Sulphate to Epidural Bupivacaine and Morphine on Post-Thoracotomy Pain Management: A Randomized, Double-Blind, Clinical Trial.

Post-thoracotomy pain is very severe and may cause pulmonary complications. Thoracic epidural analgesia can greatly decrease the pain experience and its consequences. However, finding new methods to decrease the amount of administered opioids is an important issue of research. We aimed to evaluate the effect of adding epidural magnesium sulphate to bupivacaine and morphine on pain control and the amount of opioid consumption after thoracotomy. Eighty patients undergoing thoracotomy at a tertiary cardiothoracic referral centre were enrolled in a randomized, double-blind trial. Patients were randomly allocated to two groups. Bupivacaine (12.5 mg) and morphine (2 mg) were administered epidurally to all patients at the end of operation. Patients in the magnesium (Mg) group received epidural magnesium sulphate (50 mg), and patients in the control (C) group received normal saline as an adjuvant. Visual analogue scale (VAS) score and the amount of morphine consumption were measured during 24 hr post-operation. Thirty-nine patients in the Mg group and 41 patients in the C group completed the study. Patients in the Mg group had significantly less VAS score at recovery time (p < 0.05), 2 hr (p < 0.01) and 4 hr (p < 0.05) after surgery. The patient-controlled analgesia pump was started earlier in the C group than in the Mg group (p < 0.05). The amount of morphine needed in the Mg group was significantly lower than in the C group (5.64 ± 1.69 mg/24 hr versus 8.44 ± 3.98 mg/24 hr; p < 0.001). Pruritus was seen in the C group (9.7%) and absent in the Mg group (p < 0.05). Co-administration of magnesium sulphate with bupivacaine and morphine for thoracic epidural analgesia after thoracotomy leads to a reduction in post-operative pain score and the need for opioid administration.

Cardiovascular and respiratory effects of lumbosacral epidural bupivacaine in isoflurane-anesthetized dogs: The effects of two volumes of 0.25% solution.

The purpose of this study was to compare cardiovascular and respiratory effects of two volumes of bupivacaine 0.25% (0.2 mL kg-1—treatment BUP02—and 0.4 mL kg-1 –treatment BUP04) administered epidurally at the lumbosacral intervertebral space in dogs anesthetized with isoflurane. This experimental prospective randomized crossover design trial used six mixed breed adult dogs, four neutered males and two spayed females. Each dog was anesthetized on three different occasions: the first for isoflurane minimum alveolar concentration (MAC) measurement, and the following two assigned treatments (BUP02 or BUP04). On the two treatment days, anesthesia was induced and maintained with isoflurane at 1.3 MAC during the experiments. Cardiovascular and respiratory measurements were recorded before (T0) and 5, 15, 30, 60 and 90 minutes after the epidural administration of bupivacaine. Comparisons between and within groups were performed by a mixed-model ANOVA and Friedman’s test when appropriate followed by Bonferroni post-hoc test or Dunnet’s test to compare time points within each treatment with T0 (p < 0.05). Mean arterial pressure decreased significantly from 15 to 90 minutes after the administration of BUP02 and from 5 to 60 minutes in BUP04, with lower values in BUP04 than in BUP02 lasting up to 30 minutes after bupivacaine administration. No significant changes in cardiac output and systemic vascular resistance were observed in either treatment. Hypoventilation was only detected in BUP04. Hemoglobin concentration and arterial oxygen content decreased after both treatment of bupivacaine with no significant decrease in oxygen delivery. Two dogs in BUP04 developed Horner’s syndrome. The epidural administration of 0.4 mL.kg-1 of bupivacaine to dogs in sternal recumbency anesthetized with isoflurane 1.3 MAC caused more cardiovascular and respiratory depression than 0.2 mL.kg-1.

Bupivacaine 0.5% vs. levobupivacaine 0.5% for epidural anaesthesia for caesarean section: a comparative study

Background: Levobupivacaine has been purported to be as efficacious as Bupivacaine for epidural anaesthesia in recent literature.Methods: With the intent to study the same in caesarean section cases in our set up, we observed various intra- and post-operative variables in two groups (Levobupivacaine and Bupivacaine) of 60 healthy parturients. Sixty parturients for elective caesarean section were allocated randomly to receive epidural block with 10-20 ml of either 0.5% Levobupivacaine with Fentanyl 25µg or 0.5% Bupivacaine with Fentanyl 25µg to reach T6 level.Results: Mean total volume in Bupivacaine group was 15.23ml and in Levobupivacaine group was 12.76 ml. The difference was statistically significant. There was significant difference between the groups in the sensory block. The onset of analgesia was earlier in Levobupivacaine group. Mean time was 6.20 minutes in Bupivacaine group and 4.36 minutes in Levobupivacaine group. The duration of motor block was significantly short in Levobupivacaine group. Mean Time for recovery from motor block in Bupivacaine group was 2.5 hours and in Levobupivacaine group 1.5 hours. Mean time to achieve T6 height was earlier in Levobupivacaine group i.e. 16.46 minutes in Bupivacaine group and 13.26 minutes in Levobupivacaine group. Duration of postoperative analgesia was similar. There was no significant difference in neonatal outcome.Conclusions: Levobupivacaine was found to fare better than Bupivacaine in the studied intra and post-operative parameters and is hence recommended over racemic Bupivacaine for epidural block in patients undergoing elective cesarean section.

Epidural bupivacaine and dexmedetomidine versus bupivacaine and opioids for lower vascular surgery

Objective The purpose of this study was to assess dexmedetomidine as an adjuvant to bupivacaine as a good alternative to other adjuvants like fentanyl in epidural anesthesia. Patients and methods Ninety patients between the age of 40 and 60 years with American Statistical Association status I–III planned for elective lower abdomen surgery were enrolled in a double-blind comparative study. Patients were randomized to one of three group: group A (n = 30) patients received bupivacaine, group B (n = 30) patients received bupivacaine and fentanyl, and group D (n = 30) patients received bupivacaine and dexmedetomidine. Result Regarding demographic data, no statistically significant difference was observed among the three groups. There was a statistically highly significant difference in onset of sensory block, time to achieve peak sensory level, two-segment regression time, and duration of sensory block among the three groups. In motor block, there was a statistically highly significant difference in onset of motor block and duration of motor block. Conclusion The use of dexmedetomidine as an adjuvant to bupivacaine was a good alternative to other adjuvants like fentanyl in epidural anesthesia, and dexmedetomidine had an edge over fentanyl as an adjuvant when used with bupivacaine in epidural anesthesia.

A Comparative Study of Clonidine &amp; Dexmedetomidine as an Adjuvant with Bupivacaine in Epidural Anaesthesia

A Comparative Study of Clonidine &amp; Dexmedetomidine as an Adjuvant with Bupivacaine in Epidural Anaesthesia

Wolff-Parkinson White syndrome in a parturient with rheumatic heart disease for caesarean section - Anaesthesia management.

Wolff-Parkinson White syndrome in a parturient with rheumatic heart disease for caesarean section - Anaesthesia management.

Comparison of Efficacy of Epidural Ropivacaine versus Bupivacaine for Postoperative Pain Relief in Total Knee Replacement Surgeries.

Background:Epidural analgesia has become the standard of care for knee replacement surgeries worldwide. Bupivacaine has been used successfully for many years. Epidural ropivacaine is now being used increasingly and seems to have benefits other than just pain relief, in terms of a better safety profile.Aim:To compare the efficacy of bupivacaine 0.125% (Group B) versus two concentrations of ropivacaine 0.1% (Group R1) and 0.2% (Group R2), in terms of pain scores, requirement of rescue analgesia, related adverse effects, and duration of postoperative (PO) hospital stay.Materials and Methods:A retrospective study was conducted from the acute pain service data of patients who underwent joint replacement surgeries in one or both limbs, over a span of 6 months. Patients were allocated to and analyzed under one of the three groups based on the drug concentration used postoperatively by epidural infusion. Data retrieved were demographic data, daily average visual analog scale (VAS) pain scores, rescue analgesia given, adverse effects, and PO hospital stay days for all three groups.Results:Demographic data were comparable between the three groups. Daily average VAS pain scores on days 1 and 2 were significantly higher in Group R1. Groups B and R2 were comparable. There was significantly more requirement of rescue analgesia in Group R1 on day 1. Day 2 showed no significant difference in rescue analgesic requirement in all three groups. Days of PO hospital stay were significantly higher in Group R1. Adverse effects such as hypotension and delayed motor block were higher in Group B.Conclusion:Ropivacaine 0.2% and bupivacaine 0.125% were equally efficacious in terms of VAS pain scores, rescue analgesic requirement, and duration of PO hospital stay, but ropivacaine had a better safety profile in terms of less hypotension and lesser motor block.

Ropivacaine has no advantage over bupivacaine in thoracic epidural analgesia for patients with pectus excavatum undergoing the Nuss procedure - a single blind randomized clinical trial comparing efficacy and safety.

IntroductionPectus excavatum repair (Nuss procedure) is a painful procedure requiring effective postoperative analgesia.AimTo establish whether thoracic epidural analgesia with ropivacaine is non-inferior to epidural analgesia with bupivacaine following the Nuss procedure in children.Material and methodsThe prospective, randomized, controlled, single blind study included 81 children. Computer-generated random numbers were used to allocate treatment. All children received general anesthesia. Intraoperative and postoperative analgesia was achieved with either 0.5% and 0.1% ropivacaine (group R) or 0.375% and 0.0625% bupivacaine (group B). The Numeric Rating Scale (NRS) and the Prince Henry Hospital Pain Score (PHHPS) were used to assess postoperative pain directly after and 1, 8, 20 and 24 hours after awakening from general anesthesia. NRS scores of more than 2 and a PHHPS score of more than 1 were considered as pain requiring intervention. Hemodynamic stability and side effects were also compared between the groups.ResultsThe durations of the procedure and extubation times in groups R and B were similar (59 ±7 vs. 56 ±10 minutes and 9 ±5 vs. 10 ±5 minutes, respectively). Pain scores requiring intervention were below 10% and were recorded with similar frequency in both groups, except for one difference in the PHHPS score in favor of group R after 24 hours (12% vs. 40%, p < 0.05). The frequency of side effects and hemodynamic stability were similar in both groups.Conclusions0.1% epidural ropivacaine has no advantage over 0.0625% epidural bupivacaine for pectus excavatum repair in children.