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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 1, Jan-Feb 2019, Pages 227-234
 

Original Article

A Clinical Comparative Study between Caudal Levobupivacaine-Clonidine and Ropivacaine- Clonidine for Postoperative Analgesia in Paediatric Subumbilical Surgeries

Aiyappa DS1, Janardhanan G2, Pavitra Pushpa3

1Assistant Professor 3Senior Resident, Department of Anaesthesiology, K.V.G. Medical College and Hospital, Sullia, Karnataka 574327, India. 2Associate Professor, Department of Anaesthesiology, Kodagu Institute of Medical Sciences, Madikeri, Karnataka 571201, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.32

Abstract

Context: The use of clonidine as adjuvant to newer anaesthetic agents like levobupivacaine or ropivacaine in caudal block enhance postoperative analgesia. Aims: the purpose of the study was to compare the efficacy of levobupivacaine 0.25% with clonidine 1 mcg/kg to that of ropivacaine 0.25% with clonidine 1 mcg/kg with respect to post-operative analgesia following caudal administration in children. Settings and Design: Prospective, double blinded, randomized controlled trial. Materials and Methods: sixty children aged 2-6 years, of American Society of Anesthesiologists (ASA) physical status I or II, undergoing subumbilical surgeries were randomly allocated to two groups. After induction with general anaesthesia, Group L received 1 ml/kg of 0.25% levobupivacaine with clonidine 1 mcg/kg and Group R received 1 ml/kg of 0.25% ropivacaine with clonidine 1 mcg/kg caudally. Duration of analgesia (primary outcome), pain scores, number of rescue analgesic doses and side effects if any were recorded. Statistical analysis used: All the results were tabulated and analysed statistically. After checking for normality assumption, Student’s t test was used for numerical data and Chi-square test for categorical data. p values<0.05 were considered significant. Results: Groups were comparable with respect to age, weight, sex, type and duration of surgery. Mean duration of analgesia in Group L was 11.05±0.26 versus 10.86±0.22 hours in Group R, hence comparable between the two groups. None of the groups had nausea, vomiting, bradycardia or hypotension and no significant sedation was noted. Conclusion: Clonidine(1 mcg/kg) when used as an adjuvant in caudal block along with either levobupivacaine 0.25% or ropivacaine 0.25% produces similar post-operative analgesia with fewer side effects.


Keywords : Levobupivacaine; Ropivacaine; Clonidine; Caudal block; CHIPPS score.
Corresponding Author : Janardhanan G