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 |
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Pages (from-to) | 128-135 |
Number of pages | 8 |
Journal | Paediatric Anaesthesia |
Volume | 21 |
Issue number | 2 |
DOIs | |
Publication status | Published - Feb 2011 |
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