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Ropivacaine‐clonidine combination for caudal blockade in children
Author(s) -
Ivani G.,
Negri P.,
Conio A.,
Amati M.,
Roero S.,
Gian S.,
Lönnqvist P. A.
Publication year - 2000
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2000.440415.x
Subject(s) - ropivacaine , medicine , clonidine , sedation , anesthesia , analgesic , blockade , local anesthetic , receptor
Background: Adding clonidine to weak ropivacaine solutions (<0.2%) could potentially enhance analgesia as well as further reduce the risk for unwanted motor blockade. The aim of the present study was to compare the postoperative pain‐relieving quality of a ropivacaine 0.1%‐clonidine mixture to that of plain ropivacaine 0.2% following caudal administration in children. Methods: In a prospective, observer‐blinded fashion, 40 ASA 1 paediatric patients undergoing subumbilical surgery were randomly allocated to receive a caudal injection of either plain ropivacaine 0.2% (1 ml/kg) (R0.2) or a mixture of ropivacaine 0.1% with clonidine 2 μg/kg (1 ml/kg) (R0.1C). Objective pain scale score and need for supplemental analgesia were used to evaluate analgesia during the first 24 h postoperatively. Residual postoperative sedation was also assessed. Results: A significantly higher number of patients in the R0.1C group (18/20) could be managed without supplemental analgesia during the first 24 h postoperatively compared to the R0.2 group (11/20) ( P =0.034). Both the degree and the duration of postoperative sedation was similar in both groups. No signs of postoperative motor blockade were observed. Conclusions: The combination of clonidine (2 μg/kg) and ropivacaine 0.1% is associated with an improved quality of postoperative analgesia compared to plain 0.2% ropivacaine. The improved analgesic quality of the clonidine‐ropivacaine mixture is achieved without causing any significant degree of postoperative sedation.