Comparative study of postoperative analgesia between ultrasound guided caudal anaesthesia using Ropivacaine and low dose clonidine-ropivacaine combination in pediatric patients posted for hernia surgery

DR. TANUSHREE MONDAL; DR. RAJASREE BISWAS

Volume : IX, Issue : I, January - 2020

Comparative study of postoperative analgesia between ultrasound guided caudal anaesthesia using Ropivacaine and low dose clonidine-ropivacaine combination in pediatric patients posted for hernia surgery

Dr. Tanushree Mondal, Dr. Rajasree Biswas

Abstract :

Background: Caudal anaesthesia is most commonly used regional anaesthesia technique for infraumbilical surgeries like hernia repair in paediatric patients. Ropivacine is preferred for its less systemic toxicity and less motor blockade property, but has short duration of analgesia. Clonidine is used as an adjuvant in various concentrations to increase the duration of analgesia after single shot caudal anaesthesia.Caudal clonidine 2µg/kg with 0.25% ropivacaine, significantly prolonged the duration of analgesia, but had postoperative hypotension and prolonged sedation.Therefore to avoid such complications, we compared the efficacy of caudal(ultrasound guided) clonidine in lower dose (1µg/kg) as an adjuvant with 0.2% ropivacaine on duration of analgesia, hemodynamic stability and sedation in pediatric patients undergoing hernia surgery in a prospective, randomized, double blinded manner. Methods: 60 patients of age group 1–10 years, ASA physical status I and II were randomly allocated to either group R or RC. . Patients in group R received ropivacaine 0.2%, 1 ml/kg; group RC received ropivacaine 0.2% plus clonidine 1mcg/kg, total volume being same 1 ml/kg. Hemodynamic parameters, duration of analgesia and post–operative sedation were noted throughout the peri and postoperative period. Results: There was no significant difference in hemodynamic parameters and Post–operative sedation score in both groups. Duration of analgesia in group RC (9.876±0.9176 hours) was significantly more (P<0.001) than that in group R (5.701±0.6075 hours). Conclusion: Single shot USG guided caudal block with 0.2% ropivacaine combined with clonidine 1mcg/kg provided prolonged duration of analgesia post–operatively without any hemodynamic side effects and post–operative sedation.