The Effect of Addition of Clonidine to Bupivacaine in Caudal Block On the Duration of Analgesia in Children Undergoing Herniotomy

Abstract

Background: Caudal epidural analgesia is a frequently performed regional block in childhood analgesia. However, its effects are limited by short duration of action using local anaesthetics alone.
Objective: To evaluate the efficacy of caudal block in children using bupivacaine augmented with clonidine for elective inguinal herniotomy
Methodology: This was a cross sectional study of children aged 2–6 years scheduled for elective inguinal herniotomy. Fifty-two children in American Society of Anesthesiologists (ASA) physical status I or II were randomly divided into two groups I(BS) and II(BC) of 26 each. Group I received plain bupivacaine with saline while group II received plain bupivacaine combined with clonidine. The outcome measure assessed was post-operative pain scores using Objective Pain Scale (OPS) and the results were analyzed using SPSS (Statistical Package for Social Sciences version 17 Chicago, Illinois) and presented as mean, frequencies and counts. Parametric data were compared using student’s t- test. A p value of < 0.05 was considered significant.
Results: The groups were comparable in terms of age, weight and height. The mean duration of analgesia in clonidine group (8.16 ± 1.70 hours) was significantly longer than saline group (4.00 ± 1.41 hours, p=0.001). Pain scores were lower in the clonidine group. There are no significant changes in the haemodynamic variables in both groups.
Conclusion: This study demonstrated that the addition of clonidine to plain bupivacaine in a single shot caudal block prolonged the duration of postoperative analgesia without increasing the incidence of side effects.