Spinal versus peripheral effects of adjunct clonidine: comparison of the analgesic effect of a ropivacaine-clonidine mixture when administered as a caudal or ilioinguinal-iliohypogastric nerve blockade for inguinal surgery in children.
Paediatr Anaesth
; 12(8): 680-4, 2002 Oct.
Article
en En
| MEDLINE
| ID: mdl-12472703
ABSTRACT
BACKGROUND:
The adjunctive use of clonidine to local anaesthetics has been reported to enhance analgesia both after spinal and peripheral administration. However, no attempt has been made to compare spinal and peripheral application of clonidine in the same surgical context in order to further explore the mechanism for the analgesic action of clonidine when administered together with local anaesthetics.METHODS:
Using a prospective, randomized, observer-blinded study design, 40 patients, aged 1-7 years, who were undergoing elective surgery for inguinal hernia repair or orchidopexy, were randomly allocated to receive either a caudal block (group C n = 20; ropivacaine 0.2%, 1 ml.kg-1 + clonidine 2 micro g.kg-1) or an ilioinguinal-iliohypogastric nerve block (group I n = 20; ropivacaine 0.2%, 0.4 ml.kg-1 + clonidine 2 micro g.kg-1) following the induction of a standardized sevoflurane based anaesthetic. Postoperative analgesia [maximum Objective Pain Scale (OPS) score and requirement for supplemental analgesia] and sedation (three-point scale) were assessed at predetermined intervals during the first 24 h postoperatively.RESULTS:
Fourteen children in group I and nine children in group C did not require rescue analgesia (P = 0.17). No difference in maximum OPS scores could be detected between the two study groups. The mean time to full recovery regarding sedation was 149 min and 153 min in groups C and I, respectively.CONCLUSIONS:
This pilot study demonstrates a trend for better postoperative analgesia following peripheral administration of clonidine compared with central application. However, the main mechanism for the adjunct analgesic effect of clonidine when administered together with local anaesthetics requires further study.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Clonidina
/
Anestésicos Combinados
/
Amidas
/
Hernia Inguinal
/
Anestesia Caudal
/
Anestésicos Locales
/
Bloqueo Nervioso
Tipo de estudio:
Clinical_trials
/
Observational_studies
Límite:
Child
/
Child, preschool
/
Humans
/
Infant
Idioma:
En
Revista:
Paediatr Anaesth
Asunto de la revista:
ANESTESIOLOGIA
/
PEDIATRIA
Año:
2002
Tipo del documento:
Article
País de afiliación:
Italia