La adición de clonidina a la anestesia caudal en niños aumenta la duración de la analgesia postoperatoria
Addition of clonidine in caudal anesthesia in children increases duration of post-operative analgesia.
Lak M, Araghizadeh H, Shayeghi S, Khatibi B.
Trauma Mon. 2012 Jan;16(4):170-4. doi: 10.5812/kowsar.22517464.3393. Epub 2012 Jan 15.
Abstract
BACKGROUND: Pain in infancy is a developmental process. Due to the underdeveloped pain pathways in the spinal cord, the threshold of stimulation and sensation of pain is low at birth and has potential impacts on increasing the central effects of pain. Primary trauma during infancy can cause long term changes in structure and function of pain pathways that continue until adulthood. Lack of pain management in children can result in morbidity and mortality. OBJECTIVES: In this study we examined the duration of post-operative analgesia in children when clonidine is added to bupivacaine in caudal anesthesia. MATERIALS AND METHODS: In this clinical trial, 40 children aged 1-8 years who were candidates for elective inguinal hernia repair were studied. Induction and maintenance of anesthesia were achieved using sodium thiopenthal, halothane and nitrous oxide. Children were randomly divided into 2 groups in a double-blind fashion, and were given caudal anesthesia with 0.125% bupivacaine (1ml/kg) alone or b bupivacaine plus 2 μg/kg clonidine. Blood pressure and heart rate were recorded peri-operatively. Analgesia was evaluated using objective pain scale (OPS) and sedation was assessed using Ramsay sedation scale (RSS). Acetaminophen was administered rectally for cases with OPS score greater than five. RESULTS: Duration of analgesia was found to be significantly longer in the group given bupivacaine plus clonidine (mean 417.50 min vs. 162.00 min). Peri-operative hypotension or bradycardia, post-operative respiratory depression, nausea or vomiting were not recorded in any patient. CONCLUSIONS: We concluded that addition of clonidine to bupivacaine prolongs the duration of post-operative analgesia without any respiratory or hemodynamic side-effects.
KEYWORDS:Analgesia; Anesthesia; Bupivacaine; Caudal; Clonidine
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3989567/pdf/traumamon-16-170.pdf
Analgesia postoperatoria en niños utilizando clonidina o fentanilo con ropivacaína caudal
Postoperative analgesia in children when using clonidine or fentanyl with ropivacaine given caudally.
Shukla U, Prabhakar T, Malhotra K.
J Anaesth Clin Pharcol 2011;27:205.
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.
KEYWORDS: Caudal epidural; clonidine; fentanyl; pediatric; postoperative analgesia; ropivacaine
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2011;volume=27;issue=2;spage=205;epage=210;aulast=Shukla;type=2
Clonidina caudal para reducción abierta de cadera en pacientes pediátricos
Dra. María de Lourdes González-Flores, Dr. Efraín Peralta-Zamora, Dra. Guadalupe Zaragoza-Lemus,*Dr. Salomón Sergio Flores-Hernández
Rev Mex Anestesiol Vol. 30. No. 4 Octubre-Diciembre 2007 pp 201-207
http://www.medigraphic.com/pdfs/rma/cma-2007/cma074e.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Addition of clonidine in caudal anesthesia in children increases duration of post-operative analgesia.
Lak M, Araghizadeh H, Shayeghi S, Khatibi B.
Trauma Mon. 2012 Jan;16(4):170-4. doi: 10.5812/kowsar.22517464.3393. Epub 2012 Jan 15.
Abstract
BACKGROUND: Pain in infancy is a developmental process. Due to the underdeveloped pain pathways in the spinal cord, the threshold of stimulation and sensation of pain is low at birth and has potential impacts on increasing the central effects of pain. Primary trauma during infancy can cause long term changes in structure and function of pain pathways that continue until adulthood. Lack of pain management in children can result in morbidity and mortality. OBJECTIVES: In this study we examined the duration of post-operative analgesia in children when clonidine is added to bupivacaine in caudal anesthesia. MATERIALS AND METHODS: In this clinical trial, 40 children aged 1-8 years who were candidates for elective inguinal hernia repair were studied. Induction and maintenance of anesthesia were achieved using sodium thiopenthal, halothane and nitrous oxide. Children were randomly divided into 2 groups in a double-blind fashion, and were given caudal anesthesia with 0.125% bupivacaine (1ml/kg) alone or b bupivacaine plus 2 μg/kg clonidine. Blood pressure and heart rate were recorded peri-operatively. Analgesia was evaluated using objective pain scale (OPS) and sedation was assessed using Ramsay sedation scale (RSS). Acetaminophen was administered rectally for cases with OPS score greater than five. RESULTS: Duration of analgesia was found to be significantly longer in the group given bupivacaine plus clonidine (mean 417.50 min vs. 162.00 min). Peri-operative hypotension or bradycardia, post-operative respiratory depression, nausea or vomiting were not recorded in any patient. CONCLUSIONS: We concluded that addition of clonidine to bupivacaine prolongs the duration of post-operative analgesia without any respiratory or hemodynamic side-effects.
KEYWORDS:Analgesia; Anesthesia; Bupivacaine; Caudal; Clonidine
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3989567/pdf/traumamon-16-170.pdf
Analgesia postoperatoria en niños utilizando clonidina o fentanilo con ropivacaína caudal
Postoperative analgesia in children when using clonidine or fentanyl with ropivacaine given caudally.
Shukla U, Prabhakar T, Malhotra K.
J Anaesth Clin Pharcol 2011;27:205.
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.
KEYWORDS: Caudal epidural; clonidine; fentanyl; pediatric; postoperative analgesia; ropivacaine
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2011;volume=27;issue=2;spage=205;epage=210;aulast=Shukla;type=2
Clonidina caudal para reducción abierta de cadera en pacientes pediátricos
Dra. María de Lourdes González-Flores, Dr. Efraín Peralta-Zamora, Dra. Guadalupe Zaragoza-Lemus,*Dr. Salomón Sergio Flores-Hernández
Rev Mex Anestesiol Vol. 30. No. 4 Octubre-Diciembre 2007 pp 201-207
http://www.medigraphic.com/pdfs/rma/cma-2007/cma074e.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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