Comparative analysis of caudal ropivacaine with clonidine vs ropivacaine alone with regards to hemodynamic changes, analgesic potency and side effects in children

Abstract

Pain management is an essential component of care provided by pediatric anaesthesiologists. That specially holds true due to inability of this group of patients to report their overall experience of surgical procedures like adults. Caudal analgesia is one of the most popular regional anaesthetic techniques employed in children undergoing surgery for lower abdominal, urological, and lower limb operations. Of all the major advantages that this technique has, there is one major disadvantage of short duration of anesthesia. In children it is observed that combination of ropivacaine and clonidine administered caudally has shown to prolong the effects of analgesia. The present clinical study is therefore undertaken to compare caudal ropivacaine with clonidine and ropivacaine alone with regards to hemodynamic changes, analgesic potency and side effects in children. This study included 60 children of the age group 5-10 years ASA grade I and II, of either sex, coming for various elective infra-umbilical surgical procedures who were divided into two groups each comprising of 30 subjects. Group A received plain 0.20% Ropivacaine (1ml/kg) and Group B received 0.20%Ropivacaine (1ml/kg) with clonidine 1µg/kg and the effects were analysed on various parameters.In our study, we chose 0.20% ropivacaine which provides better quality of analgesia and clonidine 1.0μg/kg which prolongs the duration of analgesia significantly while avoiding the side effects like excessive sedation and bradycardia associated with higher doses. Other hemodynamic parameters did not differ significantly in both the groups.