medigraphic.com
SPANISH

Revista Mexicana de Anestesiología

ISSN 3061-8142 (Electronic)
ISSN 0484-7903 (Print)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2007, Number 4

<< Back Next >>

Rev Mex Anest 2007; 30 (4)

Caudal clonidine for open hip reduction in pediatric patients

González-Flores ML, Peralta-Zamora E, Zaragoza-Lemus G, Flores-Hernández SS
Full text How to cite this article

Language: Spanish
References: 20
Page: 201-207
PDF size: 116.38 Kb.


Key words:

Caudal blockage, clonidina, children, sedation.

ABSTRACT

Objective: To compare the efficacy and safety of caudal block with clonidine/bupivacaine versus caudal block with bupivacaine alone. Methods: The study was conducted with forty-six children, aged 1 to 8 years scheduled for open reduction of the hip in ASA physical status I-II. Inhalatory sedation was with sevoflurane (4.0 vol%); Group I caudal block was with bupivacaine 0.25% 1.4 mL/kg and group 2 caudal block was with clonidine 2 µg/kg plus bupivacaine 0.25% 1.4mL/kg. Anesthesia was maintained with sevoflurane 10-1.5 vol%. Results: The duration of surgery and anesthesia were the same. Group 2 had longer duration of analgesia than group 1 (13.06 vs 7.65 h). The blood pressure and cardiac rate were lower in group 2 (p‹.05). Arterial saturation was similar. Group 2 had longer sedation. 17.3% of group 1 and 8.7% of group 2 had vomit (p = 0.03). Conclusions: Adding clonidine (2 µg/kg) to bupivacaine (0.25% 1.4 ml/kg) provided good post-surgical analgesia without significant haemodynamic changes.


REFERENCES

  1. McGown RG. Caudal analgesia in children-five hundred cases for procedures below the diaphragm. Anaesthesia 1982;37:806-818.

  2. Broadman LM, Hannallah RS, Norden JM, et al. Kiddies caudals: experience with 1,154 consecutive cases without complications. Anesth Analg 1987;66:S18.

  3. Dalens B, Hasnaoui A. Caudal anesthesia in pediatric surgery: success rate and adverse effects in 750 consecutive patients. Anesth Analg 1989;68:83-89.

  4. Brown TC, Eyres RL. Local and regional anaesthesia in children. Br J Anesth 1999;83:65-77.

  5. Cebrián J. Bloqueos nerviosos periféricos más frecuentes en anestesiología pediátrica. Act Anest Reanim 2001;11:47-60.

  6. Giaufré E, Dalens B, Gombert A. Epidemiology and morbidity of regional anaesthesia in children: a one-year prospective survey of the French Language Society of Pediatric Anesthesiologists. Anesth Analg 1996;83:904-912.

  7. Tucker GT. Pharmacokinetics of local anaesthetics. Br J Anaesth 1986;58:717-31.

  8. Warner MA, Kunkel SE, Offord KO et al. The effects of age, epinephrine and operative site on duration of caudal analgesia in pediatric patients. Anesth Analg 1987;66:995-998.

  9. Campbell FA, Yentis SM, Fear DW, Bissonnette B. Analgesic efficacy and safety of a caudal bupivacaine-fentanyl mixture in children. Can J Anaesth 1992;39:661-664.

  10. Naguib M, Sharif AM, Seraj M, et al. Ketamine for caudal analgesia in children: comparison with caudal bupivacaine. Br J Anaesth 1991; 67: 559-564.

  11. Brock JG, Kallichurum S, Mankowitz E. Intrathecal ketamine with preservative: histological effects on spinal nerve roots of baboons. S Afr Med J 1982;61:440-441.

  12. Eisenach J, Detweiler D, Hood D. Hemodynamic and analgesic actions of epidurally administered clonidine. Anesthesiology 1993;78:277-287.

  13. Eisenach JC, De Kock M, Klimscha W. Alpha-2 adrenergic agonist for regional anesthesia: A clinical review of clonidine. Anesthesiology 1996;85:655-674.

  14. Jamali S, Monin S, Begon C, Dubousset AM, Ecoffey C. Clonidine in pediatric caudal anesthesia. Anesth Analg 1994;78:663-666.

  15. Lee JJ, Rubin AP. Comparison of a bupivacaine-clonidine mixture with plain bupivacaine for caudal analgesia in children. Br J Anaesth 1994;72:258-262.

  16. Klimscha W, Chiari A, Michalek-Sauberer A, Wildling E, Lerche A, Lorbe C, Brinkmann H, Semsroth M. The efficacy and safety of a clonidine/bupivacaine combination in caudal blockade for pediatric hernia repair. Anesth Analg 1998; 86:54-61.

  17. Joshi W, Connelly NR, Freeman K, Reuben SS. Analgesic effect of clonidine added to bupivacaine 0.125% in paediatric caudal blockade. Paediatric Anaesth 2004;16:483-486.

  18. Sharpé P, Klein JR, Thompson JP. Analgesia for circumcision in a paediatric population: comparison of caudal bupivacaine alone with bupivacaine plus two doses of clonidine. Paediatric Anaesth 2001;11:695-700.

  19. Bouchut JC, Dubois R, Gordard J. Clonidine in preterm-infant caudal anesthesia may be responsible for postoperative apnea. Reg Anesth Pain Med 2001;26:83-85.

  20. Breschan C, Krumpholz R, Likar R, et al. Can a dose of 2 µg/kg caudal clonidine cause respiratory depression in neonates? Paediatric Anesth 1999;9:81-83.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Mex Anest. 2007;30