Comparación de analgesia caudal con ropivacaína vs. ropivacaína con clonidina en niños. Estudio randomizado controlado
Comparison of caudal analgesia between ropivacaine and ropivacaine with clonidine in children: A randomized controlled trial.
Laha A, Ghosh S, Das H.
Saudi J Anaesth. 2012 Jul;6(3):197-200. doi: 10.4103/1658-354X.101199.
Abstract
BACKGROUND: Addition of clonidine to ropivacaine (0.2%) can potentially enhance analgesia without producing prolonged motor blockade. The aim of the present study was to compare the post-operative pain relieving quality of ropivacaine 0.2% and clonidine mixture to that of plain ropivacaine 0.2% following caudal administration in children. METHODS: In a prospective, double-blinded, randomized controlled trial, 30 ASA 1 pediatric patients undergoing infraumbilical surgery were randomly allocated to receive a caudal injection of either plain ropivacaine 0.2% (1 ml/kg) (group A) or a mixture of ropivacaine 0.2% (1 ml/kg) with clonidine 2 μg/kg (group B). Objective pain score and need for supplemental analgesics were compared during the 1(st) 24 hours postoperatively. Residual post-operative sedation and motor blockade were also assessed. RESULTS: Significantly prolonged duration of post-operative analgesia was observed in group B (P<0.0001). Heart rate and blood pressure were not different in 2 groups. Neither motor blockade nor post-operative sedation varied significantly between the groups. CONCLUSION: The combination of clonidine (2 μg/kg) and ropivacaine 0.2% was associated with an improved quality of post-operative analgesia compared to plain 0.2% ropivacaine. The improved analgesic quality of the clonidine-ropivacaine mixture was achieved without causing any significant degree of post-operative sedation or prolongation of motor blockade.
KEYWORDS:
Caudal; clonidine; infra-umbilical surgery; paediatrics; ropivacaine
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2012;volume=6;issue=3;spage=197;epage=200;aulast=Laha;type=2
Eficacia de clonidina como adyuvante de ropivacaína en 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.
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.
KEYWORDS: Caudal analgesia; clonidine; ropivacaine
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2012;volume=28;issue=2;spage=185;epage=189;aulast=Manickam;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Comparison of caudal analgesia between ropivacaine and ropivacaine with clonidine in children: A randomized controlled trial.
Laha A, Ghosh S, Das H.
Saudi J Anaesth. 2012 Jul;6(3):197-200. doi: 10.4103/1658-354X.101199.
Abstract
BACKGROUND: Addition of clonidine to ropivacaine (0.2%) can potentially enhance analgesia without producing prolonged motor blockade. The aim of the present study was to compare the post-operative pain relieving quality of ropivacaine 0.2% and clonidine mixture to that of plain ropivacaine 0.2% following caudal administration in children. METHODS: In a prospective, double-blinded, randomized controlled trial, 30 ASA 1 pediatric patients undergoing infraumbilical surgery were randomly allocated to receive a caudal injection of either plain ropivacaine 0.2% (1 ml/kg) (group A) or a mixture of ropivacaine 0.2% (1 ml/kg) with clonidine 2 μg/kg (group B). Objective pain score and need for supplemental analgesics were compared during the 1(st) 24 hours postoperatively. Residual post-operative sedation and motor blockade were also assessed. RESULTS: Significantly prolonged duration of post-operative analgesia was observed in group B (P<0.0001). Heart rate and blood pressure were not different in 2 groups. Neither motor blockade nor post-operative sedation varied significantly between the groups. CONCLUSION: The combination of clonidine (2 μg/kg) and ropivacaine 0.2% was associated with an improved quality of post-operative analgesia compared to plain 0.2% ropivacaine. The improved analgesic quality of the clonidine-ropivacaine mixture was achieved without causing any significant degree of post-operative sedation or prolongation of motor blockade.
KEYWORDS:
Caudal; clonidine; infra-umbilical surgery; paediatrics; ropivacaine
http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2012;volume=6;issue=3;spage=197;epage=200;aulast=Laha;type=2
Eficacia de clonidina como adyuvante de ropivacaína en 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.
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.
KEYWORDS: Caudal analgesia; clonidine; ropivacaine
http://www.joacp.org/downloadpdf.asp?issn=0970-9185;year=2012;volume=28;issue=2;spage=185;epage=189;aulast=Manickam;type=2
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
