| Eficacia de clonidina como adyuvante de ropivacaína para analgesia caudal en niños con cirugía subumbilical |
Efficacy of clonidine as an adjuvant to ropivacaine for caudal analgesia in children undergoing subumbilical surgery.
Manickam A, Vakamudi M, Parameswari A, Chetan C.
Department of Anesthesiology Critical Care and Pain Medicine, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India.
J Anaesthesiol Clin Pharmacol. 2012 Apr;28(2):185-9. doi: 10.4103/0970-9185.94839.
Abstract
CONTEXT: The use of clonidine as an adjuvant to ropivacaine in different concentrations through the caudal space has been shown to improve the analgesic efficacy of local anesthetics. AIMS: The purpose of our study was to compare the efficacy of ropivacaine 0.1% with clonidine 1 mcg/kg to that of plain 0.1% and 0.2% ropivacaine for caudal analgesia in children. SETTINGS AND DESIGN: Prospective, double blind, randomized controlled trial. MATERIALS AND METHODS: Sixty children in the age group of 1-6 years undergoing subumbilical surgeries were included in the study. Group A received 1 ml/kg of 0.1% ropivacaine, group B received 1 ml/kg of 0.1% ropivacaine with clonidine 1 mcg/kg, and group C received 1 ml/kg of 0.2% ropivacaine. RESULTS: The mean duration of analgesia was 243.7 ± 99.29 min in group A, 590.25 ± 83.93 min in group B, and 388.25 ± 82.35 min in group C. The duration of analgesia was significantly prolonged in group B compared to groups A and C with the P value of 0.001. At 8 h, all the 20 children in group A had received the first rescue analgesic compared to 18 children in group C and 3 children in group B. The duration of motor blockade after extubation was 30.6 ± 7.8 min and was noted only in group C. Only 1 child in group B received two rescue medications compared to 15 (75%) children in group A and 8 (40%) children in group C. None of the groups were treated for bradycardia or hypotension and no significant sedation was noted. CONCLUSIONS: Clonidine 1 mcg/kg with ropivacaine 0.1% prolongs the duration and quality of analgesia compared to plain ropivacaine 0.1% and 0.2% without any significant sedation.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3339722/
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| Analgesia postoperatoria en niños con clonidina o fentanil con ropivacaína caudales |
Analgesia postoperatoria en niños con clonidina o fentanil con ropivacaína caudales
Postoperative analgesia in children when using clonidine or fentanyl with ropivacaine given caudally.
Shukla U, Prabhakar T, Malhotra K.
Department of Anaesthesiology and Critical Care, U.P Rural Institute of Medical Sciences and Research, Saifai, Etawah, India.
J Anaesthesiol Clin Pharmacol. 2011 Apr;27(2):205-10. doi: 10.4103/0970-9185.81842.
Abstract
BACKGROUND: The aim of the study was to compare the efficacy of clonidine and fentanyl as an additive to ropivacaine given via single shot caudal epidural in pediatric patients for postoperative pain relief. MATERIALS AND METHODS: In the present double blind study, 90 children of ASA-I-II aged 3-8 years scheduled for infraumblical surgical procedures were randomly allocated to two groups to receive either ropivacaine 0.25% 1 ml/kg + clonidine 2 μg/kg (group I) or ropivacaine 0.25% 1 μl/kg + fentanyl 1 μg/kg (group II). Caudal block was performed after the induction of general anesthesia. Postoperatively patients were observed for analgesia, sedation, hemodynamics, and side effects/complications. RESULTS: Both the groups were similar with respect to patient and various block characteristics. The analgesic properties and hemodynamics were also comparable in both groups (P > 0.05). Side effects such as respiratory depression, vomiting bradycardia were significantly less in group I than group II (P < 0.05) ensuing more patient comfort. CONCLUSIONS: The analgesic properties of clonidine and fentanyl as additives to ropivacaine in single shot caudal epidural in children are comparable but clonidine offers a more favorable side effect profile. The use of clonidine as additive to ropivacaine in caudal epidural is superior choice to fentanyl because of lack of unwanted side effects and increased patient comfort.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127300/
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