The dose-response relationship for clonidine added to a postoperative continuous epidural infusion of ropivacaine in children

Pasquale De Negri, Giorgio Ivani, Ciro Visconti, Paolo De Vivo, Per Arne Lonnqvist

Research output: Contribution to journalArticlepeer-review

Abstract

Epidurally administered clonidine enhances the quality and duration of postoperative analgesia when it is used as an adjunct to local anesthetics in children. We investigated the dose-response relationship for epidural clonidine when added to a continuous postoperative epidural infusion of ropivacaine. By use of an observer-blinded design, 55 pediatric patients (1-4 yr old) were randomly given a postoperative epidural infusion of plain ropivacaine 0.1% 0.2 mg · kg-1 · h-1 (Group R), ropivacaine 0.08% 0.16 mg · kg-1 · h-1 plus clonidine 0.04 μg · kg-1 · h-1 (Group RC1), ropivacaine 0.08% 0.16 mg · kg-1 · h-1 plus clonidine 0.08 μg · kg-1 · h-1 (Group RC2), or ropivacaine 0.08% 0.16 mg · kg-1 · h-1 plus clonidine 0.12 μg · kg-1 · h-1 (Group RC3). A clear dose-response relationship could be identified for a continuous infusion of epidural clonidine, with clonidine dosages in the 0.08-0.12 μg · kg-1 · h-1 range providing improved postoperative analgesia (reduced Children's Hospital of Eastern Ontario pain score, increased time to first supplemental analgesic demand, and a reduced total number of doses of supplemental analgesics during the first 48 h after surgery). Analgesia was improved without any signs of increased sedation or other side effects. The adjunct use of epidural clonidine in the dosage range of 0.08-0.12 μg · kg-1 · h-1 appears effective and safe for use in children.

Original languageEnglish
Pages (from-to)71-76
Number of pages6
JournalAnesthesia and Analgesia
Volume93
Issue number1
Publication statusPublished - 2001

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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