CLINICAL EVALUATION OF CLONIDINE AS AN ADJUNCT TO CAUDAL ROPIVACAINE IN PEDIATRIC INFRAUMBILICAL SURGERIES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2015, Vol 4, Issue 37
Abstract
[b]BACKGROUND[/b]: The addition of clonidine as an adjuvant has allowed the use of lower concentration of the local anaesthetic for achieving the same level of anaesthesia but with the prolonged duration of analgesia which increases the margin of safety and reduces the incidence of unwanted motor blockades. With these facts in mind we undertook the study to compare the analgesic properties of 0.25% ropivacaine with the addition of clonidine (1µg/kg) to that of ropivacaine 0.25% following caudal administration in children. [b]METHODS[/b]: After approval from ethical committee 60 children of age 1-10 yrs of ASA grade I or II undergoing elective sub umbilical surgeries were selected for the study. We gave caudal block with 0.25% ropivacaine 1ml/kg+1ml normal saline for group R or 0.25% ropivacaine 1ml/kg + clonidine 1microgram/kg+1ml normal saline to make volume 1ml for group C. To perform caudal block all patient received IV injection glycopyrolate- 0.01mg/kg, IV injection midazolam- 0.1mg/kg and IV Injection ketamine-1mg/kg. Hemodynamic parameters were observed before, during and after the surgical procedure. Quality of surgical anesthesia & requirement of supplemental midazolam/ketamine were also noted. Duration of Post-operative analgesia, pain scores, level of sedation and side effects if any were looked for and duly recorded. [b]RESULT[/b]: Duration of analgesia in group R was 6.45±0.52 hrs. and in group C was 13.01±0.89hrs i.e. significantly prolonged in group C (P<0.0001). Post-operative pain score and sedation score were also significantly better in group C (P<0.0001). The quality of surgical analgesia was also significantly excellent in group C. Other vital parameters were not statistically significant in both the groups.[b] CONCLUSION: [/b]Ropivacaine (0.25%) with clonidine (1μg/kg) in caudal block showed prolong duration of analgesia as well as better quality of surgical anaesthesia than plain ropivacaine (0.25%) in pediatric patients without any significant side effects.
Authors and Affiliations
Urmila Keshari, Sonal Awasya, Tripti Vatsalya
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