A Comparative Study of Bupivacaine (0.5%) V/S Ropivacaine (0.5%) Caudal Injections in Patients with Chronic Lower Back Pain with Lower Limb Radiculopathy (Code-T0204)

Introduction: Chronic lower back pain with lower limb radiculopathy significantly impairs daily functioning and quality of life. Caudal epidural injections are an effective intervention, with Bupivacaine and Ropivacaine being commonly used local anesthetics. This study aims to compare the efficacy and safety of 0.5% Bupivacaine and 0.5% Ropivacaine in managing chronic lower back pain with radiculopathy.

Aims and Objectives:

Aims

To assess the efficacy and functional outcomes of Bupivacaine 0.5% and 0.5% Ropivacaine as caudal epidural injections in patients of chronic lower back pain with lower limb radiculopathy.

Objectives

1. To compare the efficacy and functional outcomes of Bupivacaine and Ropivacaine as caudal injection as a treatment modality in the patients of chronic back pain with lower limb radiculopathy and to ascertain which one has better outcomes out of the two.
2. To study the adverse effects, if any, of Bupivacaine and Ropivacaine caudal epidural injection administered in patients with chronic lower back pain with lower limb radiculopathy.

Methods: A prospective, randomized comparative study was conducted on patients diagnosed with chronic lower back pain with radiculopathy. Patients were divided into two groups receiving either Bupivacaine or Ropivacaine via caudal epidural injection. Pain relief was assessed using the Visual Analogue Scale (VAS), and functional improvement was measured using the Oswestry Disability Index (ODI) at multiple follow-up intervals up to 24 weeks. Adverse effects were also documented.

Results: Both groups demonstrated significant pain relief and functional improvement over time. The mean VAS and ODI scores improved progressively in both groups. Ropivacaine showed slightly better safety outcomes with fewer side effects, while Bupivacaine exhibited a marginally longer duration of action.

Conclusion: Both Bupivacaine and Ropivacaine are effective for pain management in chronic lower back pain with radiculopathy. However, Ropivacaine offers a better safety profile, making it a preferable option for long-term pain management.

Keywords: Chronic lower back pain, Radiculopathy, Caudal injection, Bupivacaine, Ropivacaine, Pain management