Key result
Adding clonidine to bupivacaine prolongs postoperative caudal analgesia by ~7 hours vs bupivacaine alone.
Why the study?
Several adjuvants have been used to prolong the action of caudal bupivacaine in paediatric anaesthesia, but the effect of clonidine added to bupivacaine needed evaluation.
Does adding clonidine to bupivacaine for caudal analgesia prolong the duration of analgesia in children undergoing sub-umbilical surgery?
RCT (n=80)
Randomized
No
Does adding clonidine to bupivacaine for caudal analgesia prolong the duration of analgesia in children undergoing sub-umbilical surgery?
Absolute Event Rate: 12.18% vs 4.85%
p-value: p=<0.001
Adding 1 µg/kg of clonidine to 0.25% bupivacaine for caudal analgesia significantly prolongs the duration of analgesia in children undergoing lower abdominal surgeries without major side effects.
Supports adding clonidine to bupivacaine for pediatric caudal blocks; confirms extended analgesia duration in this RCT.
Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra and postoperative analgesia.Several adjuvants have been used to prolong the action of caudal bupivacaine.We evaluated the effect of clonidine added to caudal bupivacaine in prolonging the analgesia in children undergoing sub-umbilical surgery.80 children in the age group two to eight belonging to American Society of Anaesthesiologists Physical Status I & II undergoing lower abdominal surgeries were prospectively randomized to one of two groups of 40: caudal analgesia with 1 ml/kg of 0.25% bupivacaine in normal saline (Group B) or caudal analgesia with 1 ml/kg of 0.25% bupivacainewith1 µg/kg of clonidine in normal saline (Group BC).Post-operative pain was assessed for 24 hours using the Observational Pain/Discomfort Scale (OPS).The mean duration of analgesia was significantly longer in Group BC(12.18 hour) than in Group B (4.85 hour); P < 0.05.The pain score assessed using OPS scale was compared between the two groups and children in Group BC had lower pain scores, which was found to be statistically significant.The requirement of rescue medicine was lesser in Group BC.Clonidine in a dose of 1 µg/kg added to 0.25% bupivacaine for caudal analgesia during sub-umbilical surgeries significantly prolongs the duration of analgesia of bupivacaine without any major side effects.
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R. M.-M. Rajan (2017) conducted an RCT in Lower abdominal surgeries (n=80). Clonidine added to bupivacaine vs. 1 ml/kg of 0.25% bupivacaine alone was evaluated on Mean duration of analgesia (time to first rescue analgesia) (p=<0.001). Adding 1 µg/kg of clonidine to 0.25% bupivacaine for caudal analgesia significantly prolonged the mean duration of postoperative analgesia to 12.18 hours compared to 4.85 hours with bupivacaine alone.
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