Addition of Clonidine or Dexmedetomidine to Ropivacaine prolongs caudal analgesia in children

Abstract

Background: Caudal block is a common technique for pediatric analgesia, but with the disadvantage of short duration of action after single injection. We compared the analgesic effects and side-effects of dexmedetomidine and clonidine added to ropivacaine in pediatric patients undergoing lower abdominal surgeries. Materials and Methods: A study was conducted among 60 pediatric patients undergoing lower abdominal surgeries. A total of 60 American Society of Anesthesiologists (ASA) status I and II pediatric patients between the age of 1 and 6 years were enrolled in this study. The caudal block was administered with inj. ropivacaine 0.2% with clonidine 2 μg/kg (group A) and inj. ropivacaine 0.2% with dexmedetomidine 2 μg/kg (group B) after induction with general anesthesia. Hemodynamic parameters were observed before, during, and after the surgical procedure. Postoperative analgesic duration, total dose of rescue analgesia, pain scores, and any side effects were looked for and recorded. Results: Addition of dexmedetomidine or clonidine to caudal ropivacaine significantly promoted analgesic time. Also, there was statistically significant difference between dexmedetomidine and clonidine as regard to duration of analgesia. No significant difference was observed in incidence of hemodynamic changes or side effects. Conclusions: Addition of dexmedetomidine or clonidine to caudal ropivacaine significantly promoted analgesia in children undergoing lower abdominal surgeries with significant advantage of dexmedetomidine over clonidine and without an increase in incidence of side-effects.

Keywords

• Caudal analgesia
• clonidine
• dexmedetomidine