Key result
Caudal administration of ropivacaine with clonidine significantly prolonged the duration of postoperative analgesia compared to ropivacaine alone (380.71 vs. 270 minutes; P<0.05).
Why the study?
Clonidine as an adjuvant to caudal ropivacaine has been shown to improve analgesic efficacy, prompting evaluation of postoperative caudal analgesia with 0.2% ropivacaine alone versus combined with clonidine.
Does the addition of clonidine to ropivacaine improve postoperative caudal analgesia in children undergoing lower abdominal surgeries?
RCT (n=120)
Randomly allocated
Does the addition of clonidine to ropivacaine improve postoperative caudal analgesia in children undergoing lower abdominal surgeries?
The addition of clonidine to ropivacaine for caudal epidural analgesia significantly prolongs the duration of postoperative pain relief and reduces the need for rescue analgesics in children undergoing lower abdominal surgeries.
Answers are grounded in this paper and cite their sources.
May support clonidine adjunct in caudal blocks; hypothesis-generating and should not change practice without larger trials.
BACKGROUND epidural is practised in paediatric anaesthesia with the aim of providing analgesia. To use clonidine as an adjuvant to ropivacaine through space has been shown to improve analgesic efficacy of local anaesthetics. wanted to evaluate postoperative caudal analgesia with 0.2% ropivacaine and its combination with clonidine. 120 children aged between two to eight years scheduled for lower abdominal were allocated randomly into two groups. Group RO received 0.2% 1 mL/Kg and Group RO C received 0.2% ropivacaine 1 mL/Kg with in a dose of 2 µg/Kg. Postoperative pain was assessed using the pain discomfort scale (OPS) for 24 hours and rescue analgesia was if this score reached 11 or more. duration of analgesia was longest in children receiving clonidine and together (380.71 minutes vs. 270 minutes group RO) and was found be statistically significant; P ˂ 0.05. Significantly fewer doses of rescue were needed for subjects in group RO C. None of the subjects were for bradycardia or hypotension and no significant sedation was noted. No impairment was seen in either groups on awakening or during the next 24- period. administration of ropivacaine with the addition of clonidine resulted in analgesia with longer duration with decreased demand for rescue .
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Shini et al. (2020) conducted an RCT in Postoperative pain in paediatric lower abdominal surgeries (n=120). Ropivacaine with clonidine vs. 0.2% ropivacaine 1 mL/Kg alone was evaluated on Duration of analgesia (p=<0.05). Caudal administration of ropivacaine with clonidine significantly prolonged the duration of postoperative analgesia compared to ropivacaine alone (380.71 vs. 270 minutes; P<0.05).
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