<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Introduction</h3><p>Caudal epidural block is a reliable technique in paediatric patients but associated with various complications especially with higher concentration of drugs. We proposed a comparative study between levobupivacaine and ropivacaine at low concentration (0.125%) with clonidine at low dose (1 mcg/kg) taken as adjuvant. We aimed to see duration of post-operative analgesia, degree of motor blockade and other associated complications.</p></sec><sec><h3>Materials and Methods</h3><p>Eighty paediatric patients (1–6 years), American society of anaesthesiologists grade I and II, undergoing infra-umbilical surgery under general anaesthesia were randomly allocated into two groups of 40 each. Group A patients were given caudal levobupivacaine (0.125%) and Group B patients were given caudal ropivacaine (0.125%). Clonidine (1 mcg/kg) was taken as adjuvant in both the groups. Post-operative pain, sedation and motor blockade were assessed at 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours, 18 hours and 24 hours using Observational Pain Scale, modified Bromage Scale and four-point sedation score, respectively. Any other complications were also noted.</p></sec><sec><h3>Results</h3><p>Motor blockade was not associated with any of the patients. Duration of post-operative sedation was similar in both the groups. Duration of post-operative analgesia was significantly higher in Group A (p &lt; 0.0001). Adverse effects and complications were negligible in both the groups.</p></sec><sec><h3>Conclusion</h3><p>Both levobupivacaine and ropivacaine can be used safely at low concentration (0.125%) taking clonidine at low dose (1 mcg/kg) as adjuvant in paediatric caudal epidural block without significant motor blockade and other complications, duration of post-operative analgesia being significantly higher in the levobupivacaine group.</p></sec></abstract>

IntroductionCaudal epidural block is a reliable technique in paediatric patients but associated with various complications especially with higher concentration of drugs. We proposed a comparative study between levobupivacaine and ropivacaine at low concentration (0.125%) with clonidine at low dose (1 mcg/kg) taken as adjuvant. We aimed to see duration of post-operative analgesia, degree of motor blockade and other associated complications.Materials and MethodsEighty paediatric patients (1–6 years), American society of anaesthesiologists grade I and II, undergoing infra-umbilical surgery under general anaesthesia were randomly allocated into two groups of 40 each. Group A patients were given caudal levobupivacaine (0.125%) and Group B patients were given caudal ropivacaine (0.125%). Clonidine (1 mcg/kg) was taken as adjuvant in both the groups. Post-operative pain, sedation and motor blockade were assessed at 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours, 18 hours and 24 hours using Observational Pain Scale, modified Bromage Scale and four-point sedation score, respectively. Any other complications were also noted.ResultsMotor blockade was not associated with any of the patients. Duration of post-operative sedation was similar in both the groups. Duration of post-operative analgesia was significantly higher in Group A (p < 0.0001). Adverse effects and complications were negligible in both the groups.ConclusionBoth levobupivacaine and ropivacaine can be used safely at low concentration (0.125%) taking clonidine at low dose (1 mcg/kg) as adjuvant in paediatric caudal epidural block without significant motor blockade and other complications, duration of post-operative analgesia being significantly higher in the levobupivacaine group.

A Prospective Double-Blind Comparative Clinical Study between Caudal Levobupivacaine (0.125%) with Clonidine and Ropivacaine (0.125%) with Clonidine on Post-Operative Analgesia in Paediatric Patients Undergoing Infra-Umbilical Surgery

Department of Neuro-anaesthesia & Critical Care

Department of Anaesthesia & Critical Care Medicine

Romanian Journal of Anaesthesia and Intensive Care

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

IntroductionCaudal epidural block is a reliable technique in paediatric patients but associated with various complications especially with higher concentration...

	Group A	Group B	p-value
Sedation (mins)	139.125 ± 8.312	138.375 ± 9.295	0.705
Analgesia (mins)	471.75 ± 43.494	421.5 ± 26.047	<0.0001

	Group A	Group B	p-value
Age, (years), mean +/− SD	3.673 ± 1.515	3.438 ± 1.503	0.497
Weight, (kg), mean +/− SD	13.495 ± 3.355	13.352 ± 3.612	0.855
Sex (M/F)	37/3	38/2	0.739
Mean duration of surgery (minutes)	55.8 ± 2.794	55.15 ± 2.675	0.788

A Prospective Double-Blind Comparative Clinical Study between Caudal Levobupivacaine (0.125%) with Clonidine and Ropivacaine (0.125%) with Clonidine on Post-Operative Analgesia in Paediatric Patients Undergoing Infra-Umbilical Surgery

Article Category: Research Article

Publié en ligne: 10 août 2020

Pages: 52 - 57

DOI: https://doi.org/10.2478/rjaic-2020-0007

Mots clés
caudal, levobupivacaine, ropivacaine, clonidine, paediatric, infra-umbilical

© 2020 Prasad Chandrakant et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Duration of post-operative sedation and analgesia in both the groups

Demographic profile of both the groups

A Prospective Double-Blind Comparative Clinical Study between Caudal Levobupivacaine (0.125%) with Clonidine and Ropivacaine (0.125%) with Clonidine on Post-Operative Analgesia in Paediatric Patients Undergoing Infra-Umbilical Surgery

Article Category: Research Article

Publié en ligne: 10 août 2020

Pages: 52 - 57

DOI: https://doi.org/10.2478/rjaic-2020-0007

Mots cléscaudal, levobupivacaine, ropivacaine, clonidine, paediatric, infra-umbilical

© 2020 Prasad Chandrakant et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Duration of post-operative sedation and analgesia in both the groups

Demographic profile of both the groups

Mots clés
caudal, levobupivacaine, ropivacaine, clonidine, paediatric, infra-umbilical