The addition of clonidine 2 μg·kg-1 does not enhance the postoperative analgesia of a caudal block using 0.125% bupivacaine and epinephrine 1

200 000 in children: A prospective, double-blind, randomized study

Melissa Wheeler*, Arti Patel, Santhanam Suresh, Andrew G. Roth, Patrick K Birmingham, Corri L. Heffner, Charles J. Coté

*Corresponding author for this work

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: In this prospective, randomized, double-blind study, we compared the efficacy of 0.125% bupivacaine and epinephrine 1 : 200 000 with and without clonidine 2 μg·kg-1 for 'single shot' pediatric caudal analgesia. Methods: Thirty ASA I and II children, ages 2-8 years, undergoing outpatient surgical procedures below the umbilicus received 1 ml·kg-1 0.125% bupivacaine with fresh epinephrine 1 : 200 000 and clonidine 2 μg·kg-1 (group-C) or 1 ml·kg -1 0.125% bupivacaine with epinephrine 1 : 200 000 (group-NC). All patients received a standardized general anesthetic (induction with 67% N 2O in O2 and sevoflurane followed by isoflurane maintenance). Primary outcome measures were time to first rescue analgesic and number of patients requiring rescue analgesic at 4, 6, 8, 12, and 24 h after caudal placement. Secondary outcome measures included: extubation times, Objective Pain Scale (OPS) scores, sedation scores, time in postanesthesia care unit (PACU), discharge time, number of analgesic doses given in 24 h following caudal blockade, and adverse effects (vomiting, hypotension, and bradycardia). Results: There were no differences in demographics, investigated parameters, or adverse effects between groups. Conclusions: We found that the addition of clonidine 2 μg·kg-1 to 0.125% bupivacaine with fresh epinephrine 1 : 200 000 for caudal analgesia did not significantly delay the time to first rescue analgesic or decrease the overall need for rescue analgesics in children 2-8 years undergoing surgical procedures below the umbilicus.

Original languageEnglish (US)
Pages (from-to)476-483
Number of pages8
JournalPaediatric Anaesthesia
Volume15
Issue number6
DOIs
StatePublished - Jun 24 2005

Fingerprint

Bupivacaine
Clonidine
Double-Blind Method
Analgesia
Epinephrine
Analgesics
Umbilicus
Outcome Assessment (Health Care)
General Anesthetics
Isoflurane
Bradycardia
Hypotension
Vomiting
Outpatients
Maintenance
Demography
Pediatrics
Pain

Keywords

  • Analgesia
  • Bupivacaine
  • Child
  • Clonidine
  • Epinephrine
  • Local anesthesia
  • Neuraxial blockade

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

Cite this

@article{b01bed87532448d6bcfd4c7a6c0f3b1b,
title = "The addition of clonidine 2 μg·kg-1 does not enhance the postoperative analgesia of a caudal block using 0.125{\%} bupivacaine and epinephrine 1: 200 000 in children: A prospective, double-blind, randomized study",
abstract = "Background: In this prospective, randomized, double-blind study, we compared the efficacy of 0.125{\%} bupivacaine and epinephrine 1 : 200 000 with and without clonidine 2 μg·kg-1 for 'single shot' pediatric caudal analgesia. Methods: Thirty ASA I and II children, ages 2-8 years, undergoing outpatient surgical procedures below the umbilicus received 1 ml·kg-1 0.125{\%} bupivacaine with fresh epinephrine 1 : 200 000 and clonidine 2 μg·kg-1 (group-C) or 1 ml·kg -1 0.125{\%} bupivacaine with epinephrine 1 : 200 000 (group-NC). All patients received a standardized general anesthetic (induction with 67{\%} N 2O in O2 and sevoflurane followed by isoflurane maintenance). Primary outcome measures were time to first rescue analgesic and number of patients requiring rescue analgesic at 4, 6, 8, 12, and 24 h after caudal placement. Secondary outcome measures included: extubation times, Objective Pain Scale (OPS) scores, sedation scores, time in postanesthesia care unit (PACU), discharge time, number of analgesic doses given in 24 h following caudal blockade, and adverse effects (vomiting, hypotension, and bradycardia). Results: There were no differences in demographics, investigated parameters, or adverse effects between groups. Conclusions: We found that the addition of clonidine 2 μg·kg-1 to 0.125{\%} bupivacaine with fresh epinephrine 1 : 200 000 for caudal analgesia did not significantly delay the time to first rescue analgesic or decrease the overall need for rescue analgesics in children 2-8 years undergoing surgical procedures below the umbilicus.",
keywords = "Analgesia, Bupivacaine, Child, Clonidine, Epinephrine, Local anesthesia, Neuraxial blockade",
author = "Melissa Wheeler and Arti Patel and Santhanam Suresh and Roth, {Andrew G.} and Birmingham, {Patrick K} and Heffner, {Corri L.} and Cot{\'e}, {Charles J.}",
year = "2005",
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The addition of clonidine 2 μg·kg-1 does not enhance the postoperative analgesia of a caudal block using 0.125% bupivacaine and epinephrine 1 : 200 000 in children: A prospective, double-blind, randomized study. / Wheeler, Melissa; Patel, Arti; Suresh, Santhanam; Roth, Andrew G.; Birmingham, Patrick K; Heffner, Corri L.; Coté, Charles J.

In: Paediatric Anaesthesia, Vol. 15, No. 6, 24.06.2005, p. 476-483.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The addition of clonidine 2 μg·kg-1 does not enhance the postoperative analgesia of a caudal block using 0.125% bupivacaine and epinephrine 1

T2 - 200 000 in children: A prospective, double-blind, randomized study

AU - Wheeler, Melissa

AU - Patel, Arti

AU - Suresh, Santhanam

AU - Roth, Andrew G.

AU - Birmingham, Patrick K

AU - Heffner, Corri L.

AU - Coté, Charles J.

PY - 2005/6/24

Y1 - 2005/6/24

N2 - Background: In this prospective, randomized, double-blind study, we compared the efficacy of 0.125% bupivacaine and epinephrine 1 : 200 000 with and without clonidine 2 μg·kg-1 for 'single shot' pediatric caudal analgesia. Methods: Thirty ASA I and II children, ages 2-8 years, undergoing outpatient surgical procedures below the umbilicus received 1 ml·kg-1 0.125% bupivacaine with fresh epinephrine 1 : 200 000 and clonidine 2 μg·kg-1 (group-C) or 1 ml·kg -1 0.125% bupivacaine with epinephrine 1 : 200 000 (group-NC). All patients received a standardized general anesthetic (induction with 67% N 2O in O2 and sevoflurane followed by isoflurane maintenance). Primary outcome measures were time to first rescue analgesic and number of patients requiring rescue analgesic at 4, 6, 8, 12, and 24 h after caudal placement. Secondary outcome measures included: extubation times, Objective Pain Scale (OPS) scores, sedation scores, time in postanesthesia care unit (PACU), discharge time, number of analgesic doses given in 24 h following caudal blockade, and adverse effects (vomiting, hypotension, and bradycardia). Results: There were no differences in demographics, investigated parameters, or adverse effects between groups. Conclusions: We found that the addition of clonidine 2 μg·kg-1 to 0.125% bupivacaine with fresh epinephrine 1 : 200 000 for caudal analgesia did not significantly delay the time to first rescue analgesic or decrease the overall need for rescue analgesics in children 2-8 years undergoing surgical procedures below the umbilicus.

AB - Background: In this prospective, randomized, double-blind study, we compared the efficacy of 0.125% bupivacaine and epinephrine 1 : 200 000 with and without clonidine 2 μg·kg-1 for 'single shot' pediatric caudal analgesia. Methods: Thirty ASA I and II children, ages 2-8 years, undergoing outpatient surgical procedures below the umbilicus received 1 ml·kg-1 0.125% bupivacaine with fresh epinephrine 1 : 200 000 and clonidine 2 μg·kg-1 (group-C) or 1 ml·kg -1 0.125% bupivacaine with epinephrine 1 : 200 000 (group-NC). All patients received a standardized general anesthetic (induction with 67% N 2O in O2 and sevoflurane followed by isoflurane maintenance). Primary outcome measures were time to first rescue analgesic and number of patients requiring rescue analgesic at 4, 6, 8, 12, and 24 h after caudal placement. Secondary outcome measures included: extubation times, Objective Pain Scale (OPS) scores, sedation scores, time in postanesthesia care unit (PACU), discharge time, number of analgesic doses given in 24 h following caudal blockade, and adverse effects (vomiting, hypotension, and bradycardia). Results: There were no differences in demographics, investigated parameters, or adverse effects between groups. Conclusions: We found that the addition of clonidine 2 μg·kg-1 to 0.125% bupivacaine with fresh epinephrine 1 : 200 000 for caudal analgesia did not significantly delay the time to first rescue analgesic or decrease the overall need for rescue analgesics in children 2-8 years undergoing surgical procedures below the umbilicus.

KW - Analgesia

KW - Bupivacaine

KW - Child

KW - Clonidine

KW - Epinephrine

KW - Local anesthesia

KW - Neuraxial blockade

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U2 - 10.1111/j.1460-9592.2005.01481.x

DO - 10.1111/j.1460-9592.2005.01481.x

M3 - Article

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JO - Paediatric Anaesthesia

JF - Paediatric Anaesthesia

SN - 1155-5645

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