Abstract
Background: Clonidine has the potential to significantly prolong the duration of caudal epidural anesthesia. We investigated the effect of the addition of clonidine to the MLAC of levobupivacaine in a randomized controlled dose-response trial. Methods: A group of 120 children aged -1 of clonidine. The MLAC was determined according to a Dixon-Massey protocol. The primary outcome was effective surgical anesthesia. Secondary outcomes were the duration of postoperative analgesia, postoperative pain scores, clonidine side effects, and time to hospital discharge. Results: The MLAC of caudal levobupivacaine was 0.106%, 0.077%, and 0.035% with 1, 2, and 3 μg·kg-1 of clonidine, respectively. There were significant dose-dependent increases in median duration of analgesia. The incidence of delayed discharge, somnolence, and PONV was significantly increased in the 3 μg·kg-1 of clonidine group. Conclusions: Clonidine produces a local anesthetic sparing effect with a dose-dependent decrease in levobupivacaine MLAC for caudal anesthesia. In addition, there is a dose-dependent prolongation of postoperative analgesia following lower abdominal surgery in children. A dose of 2 μg·kg-1 of clonidine provides the optimum balance between improved analgesia and minimal side effects.
| Original language | English |
|---|---|
| Pages (from-to) | 128-135 |
| Number of pages | 8 |
| Journal | Paediatric Anaesthesia |
| Volume | 21 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2011 |
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Keywords
- anesthetic
- anesthetic techniques
- anesthetics local
- caudal
- clonidine
- ED {50}
- pharmacology
- potency
- regional
- stereoisomers
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
- Pediatrics, Perinatology, and Child Health
Cite this
Effect of epidural clonidine on minimum local anesthetic concentration (ED50) of levobupivacaine for caudal block in children. / Disma, Nicola; Frawley, Geoff; Mameli, Leila; Pistorio, Angela; Alberighi, O. D C; Montobbio, Giovanni; Tuo, Pietro.
In: Paediatric Anaesthesia, Vol. 21, No. 2, 02.2011, p. 128-135.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of epidural clonidine on minimum local anesthetic concentration (ED50) of levobupivacaine for caudal block in children
AU - Disma, Nicola
AU - Frawley, Geoff
AU - Mameli, Leila
AU - Pistorio, Angela
AU - Alberighi, O. D C
AU - Montobbio, Giovanni
AU - Tuo, Pietro
PY - 2011/2
Y1 - 2011/2
N2 - Background: Clonidine has the potential to significantly prolong the duration of caudal epidural anesthesia. We investigated the effect of the addition of clonidine to the MLAC of levobupivacaine in a randomized controlled dose-response trial. Methods: A group of 120 children aged -1 of clonidine. The MLAC was determined according to a Dixon-Massey protocol. The primary outcome was effective surgical anesthesia. Secondary outcomes were the duration of postoperative analgesia, postoperative pain scores, clonidine side effects, and time to hospital discharge. Results: The MLAC of caudal levobupivacaine was 0.106%, 0.077%, and 0.035% with 1, 2, and 3 μg·kg-1 of clonidine, respectively. There were significant dose-dependent increases in median duration of analgesia. The incidence of delayed discharge, somnolence, and PONV was significantly increased in the 3 μg·kg-1 of clonidine group. Conclusions: Clonidine produces a local anesthetic sparing effect with a dose-dependent decrease in levobupivacaine MLAC for caudal anesthesia. In addition, there is a dose-dependent prolongation of postoperative analgesia following lower abdominal surgery in children. A dose of 2 μg·kg-1 of clonidine provides the optimum balance between improved analgesia and minimal side effects.
AB - Background: Clonidine has the potential to significantly prolong the duration of caudal epidural anesthesia. We investigated the effect of the addition of clonidine to the MLAC of levobupivacaine in a randomized controlled dose-response trial. Methods: A group of 120 children aged -1 of clonidine. The MLAC was determined according to a Dixon-Massey protocol. The primary outcome was effective surgical anesthesia. Secondary outcomes were the duration of postoperative analgesia, postoperative pain scores, clonidine side effects, and time to hospital discharge. Results: The MLAC of caudal levobupivacaine was 0.106%, 0.077%, and 0.035% with 1, 2, and 3 μg·kg-1 of clonidine, respectively. There were significant dose-dependent increases in median duration of analgesia. The incidence of delayed discharge, somnolence, and PONV was significantly increased in the 3 μg·kg-1 of clonidine group. Conclusions: Clonidine produces a local anesthetic sparing effect with a dose-dependent decrease in levobupivacaine MLAC for caudal anesthesia. In addition, there is a dose-dependent prolongation of postoperative analgesia following lower abdominal surgery in children. A dose of 2 μg·kg-1 of clonidine provides the optimum balance between improved analgesia and minimal side effects.
KW - anesthetic
KW - anesthetic techniques
KW - anesthetics local
KW - caudal
KW - clonidine
KW - ED {50}
KW - pharmacology
KW - potency
KW - regional
KW - stereoisomers
UR - http://www.scopus.com/inward/record.url?scp=78651281601&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78651281601&partnerID=8YFLogxK
U2 - 10.1111/j.1460-9592.2010.03478.x
DO - 10.1111/j.1460-9592.2010.03478.x
M3 - Article
C2 - 21159021
AN - SCOPUS:78651281601
VL - 21
SP - 128
EP - 135
JO - Paediatric Anaesthesia
JF - Paediatric Anaesthesia
SN - 1155-5645
IS - 2
ER -