Title: Effects of Adding Clonidine to Bupivacaine for Caudal Analgesia in children
Authors: Raju Rajan, Anoop Prabhakaran, Linette J. Morris
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.183
Abstract
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.
Keywords: Bupivacaine, Caudal analgesia, Clonidine.
