Key result
The addition of clonidine to ropivacaine for single shot caudal epidural block significantly prolonged the mean duration of post-operative analgesia to 15 hours compared to 9 hours with ropivacaine alone.
Why the study?
The study was conducted to clinically evaluate the efficacy of caudal epidural clonidine mixed with ropivacaine in prolonging post-operative analgesia and to compare pain-free duration and side effects in children.
Does the addition of clonidine to ropivacaine in single shot caudal epidural block prolong post-operative analgesia in pediatric patients undergoing lower abdominal or perineal surgery?
RCT (n=68)
No
Does the addition of clonidine to ropivacaine in single shot caudal epidural block prolong post-operative analgesia in pediatric patients undergoing lower abdominal or perineal surgery?
Absolute Event Rate: 15% vs 9%
p-value: p=<0.001
The addition of 1 µg/kg clonidine to 0.2% ropivacaine for single-shot caudal epidural block significantly prolongs postoperative analgesia in children without causing significant adverse hemodynamic effects.
Supports adding clonidine to ropivacaine for pediatric caudal blocks; extends RCT evidence for adjuvant prolongation of analgesia.
Caudal epidural block is one of the most common regional anesthetic techniques in children being used to supplement general anesthesia for a wide variety of surgeries.The local anesthetics currently in use are safe and their pharmacological effects have been well evaluated.The aim of this study is to clinically evaluate the efficacy of caudal epidural clonidine in prolonging the post-operative analgesia when mixed with ropivacaine in children and to compare the post-operative pain-free duration and the side effects of ropivacaine with or without Clonidine.The addition of α-2 agonist, Clonidine to local anesthetic solution 0.2% ropivacaine has been shown to enhance the duration and quality of central and peripheral nerve blocks.The main advantage of Clonidine (versus opioids) is the negligible risk of respiratory depression.
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Dr Shobha Namdeo Pore (2019) conducted an RCT in Post-operative pain (n=68). Ropivacaine with Clonidine vs. 0.75 ml/kg of 0.2% Ropivacaine was evaluated on Mean duration of post-operative analgesia (p=<0.001). The addition of clonidine to ropivacaine for single shot caudal epidural block significantly prolonged the mean duration of post-operative analgesia to 15 hours compared to 9 hours with ropivacaine alone.
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