Comparative Study of Caudal Bupivacaine and Bupivacaine with Clonidine in Infra Umbilical Surgeries in Children

Abstract

Background: Caudal epidural analgesia is one of the most commonly performed regional blocks in paediatric anaesthesia for intra and post-operative analgesia. Addition of opioids like morphine, fentanyl is associated with side effects like respiratory depression, urinary retention, etc. Clonidine, an α2 agonist is known for its analgesic effects with lesser side effects. Hence, this study was conducted to know the efficacy and safety of addition of clonidine to bupivacaine in a single shot caudal block in children.Subjects and Methods:This study was conducted among 60 children in the age group of 5 – 10 years coming for various elective infraumbilical surgical procedures. They were divided into two groups of 30 each. Group A received caudal 0.25% bupivacaine (1ml/kg) and group B received caudal 0.25% bupivacaine (1ml/kg) with clonidine (1.5µg/kg). The various parameters studied were hemodynamic changes, duration of analgesia and incidence of side effects.Results:The groups were similar in age, sex and weight. The hemodynamic parameters like heart rate, blood pressure, respiratory rate were also similar between the two groups after administering caudal block. The mean duration of analgesia in group B (433.5 ± 60 min) was significantly longer (p< 0.05) than group A (250.33 ±41 min). Conclusion:This study showed that the addition of clonidine in the dose of 1.5µg/kg to 0.25% bupivacaine (1ml/kg) improved the analgesic duration and efficacy after a single shot caudal block with minimal side effects in children.