Effect of addition of clonidine to bupivacaine or ropivacaine on caudal efficacy and effectiveness in pediatric patients undergoing infraumblical surgery

Journal Title: Indian Journal of Clinical Anaesthesia - Year 2017, Vol 4, Issue 3

Abstract

Introduction: Children are not as expressive as adults, but they do feels pain equally. In the perioperative period, pain is the most alarming, upsetting and disturbing symptom for a patient. In pediatric populace, amongst the regional blocks, caudal epidurals with local anesthetics are preferred and universally practiced by anesthesiologists, but comparatively shorter period of analgesia is its major limitation. So, to improve the effectiveness of caudal epidurals, a variety of additives are used besides local anesthetics. Materials and Method: A double-blind, prospective and randomised study was carried on 60 children falling in the age group of 1- 6 years belonging to ASA I or II, posted to undergo surgery infraumblically, were allocated randomly to one of two groups of 30 each who then received injection of 0.25% bupivacaine-clonidine(2ug/kg) or 0.25% ropivacaine-clonidine (2μg/kg) @ 1ml/kg caudally. Haemodynamic variables were documented peri-operatively. Pain was assessed using the Modified Hanallah pain score for 24 hours and complications were observed in the postoperative period. Results: No statistically significant difference was observed when 2ug/kg of clonidine added to 0.25% bupivacaine or 0.25% ropivacaine caudally in pediatric patients, in procedures below the umbilicus with mean duration of analgesia with group BC and RC were mins respectively. Also no significant undesirable side effects like bradycardia, hypotension, urinary incontinence, nausea and vomiting were observed in either of these groups. Conclusion: The mean extent of analgesia was equally prolonged in both the groups postoperatively. So, clonidine in a dose of 2ug/kg added to 0.25% bupivacaine or 0.25% ropivacaine for caudal analgesia, proves safe and effective method in prolonging the duration of analgesia without producing any significant side effects.

Authors and Affiliations

Pankaj Sarangal, Chiteshwar Walia, Ruchi Gupta, Anita Kumari, KS Aujla

Keywords

Related Articles

Anaesthetic management of endobronchial ultrasound guided trans bronchial needle aspiration: Our experience with laryngeal mask airway

Introduction Endobronchial Ultrasound Guided Trans bronchial needle aspiration EBUSTBNA is a minimally invasive diagnostic modality for evaluating intra thoracic lymph nodes becoming one of the important tool in the arma...

Prospective randomized double blinded comparative study on the effects of ephedrine and phenylephrine on fetal outcome and their effects on hypotension during elective cesarean section

Introduction Hemodynamic instability during pregnancy may compromise the blood flow to the uteroplacental bed which may lead fetal acidosis We compared ephedrine and phenylephrine on fetal outcome and hypotension during...

Effects of addition of fentanyl and midazolam to local anaesthetic in lumbar epidural anaesthesia for infraumbilical surgeries

Introduction: Compared to general anaesthesia, regional anaesthetic techniques are more preferred in lower limb and lower abdominal surgeries as they have many advantages. Fentanyl a short acting opioid agonist, acts at...

Anesthesia for Neurosurgery (Part I)

The central nervous system (CNS) deserves special consideration in the perioperative setting for several reasons for an anesthetist. An understanding of neuroanatomy is essential because neuro anesthesia continues to dev...

Effect of addition of clonidine to bupivacaine or ropivacaine on caudal efficacy and effectiveness in pediatric patients undergoing infraumblical surgery

Introduction: Children are not as expressive as adults, but they do feels pain equally. In the perioperative period, pain is the most alarming, upsetting and disturbing symptom for a patient. In pediatric populace, among...

Download PDF file
  • EP ID EP313418
  • DOI 10.18231/2394-4994.2017.0069
  • Views 98
  • Downloads 0

How To Cite

Pankaj Sarangal, Chiteshwar Walia, Ruchi Gupta, Anita Kumari, KS Aujla (2017). Effect of addition of clonidine to bupivacaine or ropivacaine on caudal efficacy and effectiveness in pediatric patients undergoing infraumblical surgery. Indian Journal of Clinical Anaesthesia, 4(3), 333-337. https://europub.co.uk/articles/-A-313418