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Analgesia for circumcision in a paediatric population: comparison of caudal bupivacaine alone with bupivacaine plus two doses of clonidine
Author(s) -
Sharpe P.,
Klein J.R.,
Thompson J.P.,
Rushman S.C.,
Sherwin J.,
Wandless J.G.,
Fell D.
Publication year - 2001
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.2001.00748.x
Subject(s) - clonidine , bupivacaine , medicine , anesthesia , analgesic , local anesthetic , adverse effect , pharmacology
Background : Clonidine is often used to improve the duration and quality of analgesia produced by caudal epidural blockade, although the optimum dose of clonidine with bupivacaine remains uncertain. Methods : We compared the effect of clonidine, 1 and 2 μg·kg –1 , added to bupivacaine (1.25 mg·kg –1 ) with that of bupivacaine alone in 75 male children undergoing elective circumcision. Results : There was a trend towards increasing duration of analgesia with increasing dose of clonidine [group B (bupivacaine) 280.7 (171.6) min, C1 (bupivacaine + clonidine 1 μg·kg –1 ) 327.8 (188.3) min and C2 (bupivacaine + clonidine 2 μg·kg –1 ) 382.0 (200.6) min], although this difference was not statistically significant. Mean time to arousal from anaesthesia was significantly prolonged with clonidine 2 μg kg –1 (group C2 21.3 (13–36) min, group C1 14.0 (6–25) min and group B 14.4 (2–32) min. Supplementary analgesic requirements and incidence of adverse effects were low, with no differences between the groups. Conclusions : For paediatric circumcision, under general anaesthesia, the addition of clonidine 2 μg·kg –1 to low volume (0.5 ml·kg –1 ) caudal anaesthetics has a limited clinical benefit for children undergoing circumcision.