A COMPARATIVE CLINICAL STUDY BETWEEN EQUAL VOLUMES AND CONCENTRATIONS OF CLONIDINE AND DEXMEDITOMIDINE AS ADJUVANTS TO 0.25% ROPIVACAINE IN PAEDIATRIC CAUDAL BLOCK FOR CIRCUMCISION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2014, Vol 3, Issue 10
Abstract
[b]BACKGROUND[/b]: Caudal epidural block is a simple, safe, effective and reliable technique. Different techniques, drugs, drug combinations, doses and concentrations have been tried by many anesthesiologists. Ropivacaine produces differential neural blockade with less motor block and reduced cardiovascular and neurological toxicity compared to Bupivacaine. Adjuvants like Clonidine and Dexmeditomidine, which are alpha 2 agonists, are used along with local anesthetics to increase the duration of analgesia. Hence we are comparing 0.5µg/kg of clonidine with 0.5µg/kg of dexmedetomidine as adjuvants to 0.25% ropivacaine at a volume of 0.5ml/kg in children undergoing circumcision. [b]AIMS AND OBJECTIVES:[/b] To assess the efficacy, safety and duration of analgesia of equal volumes and concentrations of clonidine and dexmedetomidine as adjuvants to low volume and concentration of ropivacaine. [b]MATERIAL AND METHODS:[/b] Study design: comparative randomized study Sampling method: purposive sampling Statistical analysis: using student’s t test and chi square test Sample size: 60 children aged between 1 to 6 years posted for circumcision. GROUP I: 30 children received 0.25% ropivacaine 0.5ml/kg + 0.5µg/kg clonidine GROUP II: 30 children received 0.25% ropivacaine 0.5ml/kg + 0.5µg/kg dexmedetomidine. Postoperatively the duration of analgesia was assessed using the observational pain scale, the duration of sedation was assessed using the sedation score and the duration of motor block was assessed using the modified bromage scale. [b]RESULTS[/b]: The mean duration of analgesia in group I was 430.52±20.58 mins and in group II was 555.6±18.22mins.[b]CONCLUSION:[/b] The onset of action between the two groups was observed to be similar. There was about 20mins increase in the duration of sedation with the dexmedetomidine group. There was no case of motor blockade and no complications in both the groups. We observed that there was a statistically increased duration of analgesia with the dexmedetomidine group compared to clonidine group. Hence we summarize that dexmedetomidine is a better adjuvant than clonidine in prolonging the duration of analgesia when used with ropivacaine in pediatric caudal block.
Authors and Affiliations
Madhava Reddy, Ranjitha Gangadharaiah
Keywords
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- EP ID EP117345
- DOI 10.14260/jemds/2014/2160
- Views 78
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