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

Janardhanan G , Aiyappa DS1 , Janardhanan G2 , Pavitra Pushpa3

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Indian Journal of Anesthesia and Analgesia 6(1):p 227-234, Jan-Feb 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.32

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Aiyappa D S, Janardhanan G, Pavitra Pushpa. A Clinical Comparative Study between Caudal Levobupivacaine-Clonidine and Ropivacaine-Clonidine for Postoperative Analgesia in Paediatric Subumbilical Surgeries. Indian J Anesth Analg. 2019;6(1):227-234.

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Received : N/A         Accepted : N/A          Published : N/A

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.

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Aiyappa D S, Janardhanan G, Pavitra Pushpa. A Clinical Comparative Study between Caudal Levobupivacaine-Clonidine and Ropivacaine-Clonidine for Postoperative Analgesia in Paediatric Subumbilical Surgeries. Indian J Anesth Analg. 2019;6(1):227-234.

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

Keywords

Levobupivacaine; Ropivacaine; Clonidine; Caudal block; CHIPPS score.

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