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Effect of caudal clonidine on emergence agitation and postoperative analgesia after sevoflurane anaesthesia in children: Randomised comparison of two doses

BACKGROUND AND AIMS: Sevoflurane, a popular inhalational anaesthetic for children, has been associated with significant emergence agitation in the recovery phase. This study was intended to compare two doses of caudal clonidine added to ropivacaine 0.2% in order to decide on the optimal dose for pre...

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Autores principales: Saxena, Anudeep, Sethi, Ashish, Agarwal, Vikesh, Godwin, Rajan B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296357/
https://www.ncbi.nlm.nih.gov/pubmed/25624536
http://dx.doi.org/10.4103/0019-5049.147163
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author Saxena, Anudeep
Sethi, Ashish
Agarwal, Vikesh
Godwin, Rajan B
author_facet Saxena, Anudeep
Sethi, Ashish
Agarwal, Vikesh
Godwin, Rajan B
author_sort Saxena, Anudeep
collection PubMed
description BACKGROUND AND AIMS: Sevoflurane, a popular inhalational anaesthetic for children, has been associated with significant emergence agitation in the recovery phase. This study was intended to compare two doses of caudal clonidine added to ropivacaine 0.2% in order to decide on the optimal dose for prevention of sevoflurane induced emergence agitation (EA) and to get a meaningful prolongation of postoperative analgesia with minimal side effects. METHODS: Sixty-one children aged 1–7 years (American Society of Anaesthesiologists physical status I-II) received standardized general anaesthesia with inhaled sevoflurane and caudal epidural block with 0.2% ropivacaine 1 ml/kg for sub-umbilical surgeries. They were assigned randomly to two groups: (I) clonidine 1 μg/kg added to caudal ropivacaine; (II) clonidine 2 μg/kg added to caudal ropivacaine. EA and postoperative analgesia were assessed using pain/discomfort scale score and face, legs, activity, cry, consolability (FLACC) score respectively. RESULTS: EA was observed in 8 children (26.6%) in group I when compared to only 2 children (6.4%) in group II after first 15 min postoperatively. Incidences of EA at 15 min, as well as total incidence of agitation, were both significantly lower in group II when compared to group I with P < 0.05. Duration of analgesia in group I (12 [8–20] h) and group II (16 [8–20] h) was statistically comparable (P > 0.05). There was no difference in the incidence of sedation or complications. CONCLUSION: Caudal clonidine 2 μg/kg added to 0.2% ropivacaine 1 ml/kg is suggested to be the optimal dose, for prevention of EA and meaningful prolongation of postoperative analgesia with minimal side-effects.
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spelling pubmed-42963572015-01-26 Effect of caudal clonidine on emergence agitation and postoperative analgesia after sevoflurane anaesthesia in children: Randomised comparison of two doses Saxena, Anudeep Sethi, Ashish Agarwal, Vikesh Godwin, Rajan B Indian J Anaesth Clinical Investigation BACKGROUND AND AIMS: Sevoflurane, a popular inhalational anaesthetic for children, has been associated with significant emergence agitation in the recovery phase. This study was intended to compare two doses of caudal clonidine added to ropivacaine 0.2% in order to decide on the optimal dose for prevention of sevoflurane induced emergence agitation (EA) and to get a meaningful prolongation of postoperative analgesia with minimal side effects. METHODS: Sixty-one children aged 1–7 years (American Society of Anaesthesiologists physical status I-II) received standardized general anaesthesia with inhaled sevoflurane and caudal epidural block with 0.2% ropivacaine 1 ml/kg for sub-umbilical surgeries. They were assigned randomly to two groups: (I) clonidine 1 μg/kg added to caudal ropivacaine; (II) clonidine 2 μg/kg added to caudal ropivacaine. EA and postoperative analgesia were assessed using pain/discomfort scale score and face, legs, activity, cry, consolability (FLACC) score respectively. RESULTS: EA was observed in 8 children (26.6%) in group I when compared to only 2 children (6.4%) in group II after first 15 min postoperatively. Incidences of EA at 15 min, as well as total incidence of agitation, were both significantly lower in group II when compared to group I with P < 0.05. Duration of analgesia in group I (12 [8–20] h) and group II (16 [8–20] h) was statistically comparable (P > 0.05). There was no difference in the incidence of sedation or complications. CONCLUSION: Caudal clonidine 2 μg/kg added to 0.2% ropivacaine 1 ml/kg is suggested to be the optimal dose, for prevention of EA and meaningful prolongation of postoperative analgesia with minimal side-effects. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4296357/ /pubmed/25624536 http://dx.doi.org/10.4103/0019-5049.147163 Text en Copyright: © Indian Journal of Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigation
Saxena, Anudeep
Sethi, Ashish
Agarwal, Vikesh
Godwin, Rajan B
Effect of caudal clonidine on emergence agitation and postoperative analgesia after sevoflurane anaesthesia in children: Randomised comparison of two doses
title Effect of caudal clonidine on emergence agitation and postoperative analgesia after sevoflurane anaesthesia in children: Randomised comparison of two doses
title_full Effect of caudal clonidine on emergence agitation and postoperative analgesia after sevoflurane anaesthesia in children: Randomised comparison of two doses
title_fullStr Effect of caudal clonidine on emergence agitation and postoperative analgesia after sevoflurane anaesthesia in children: Randomised comparison of two doses
title_full_unstemmed Effect of caudal clonidine on emergence agitation and postoperative analgesia after sevoflurane anaesthesia in children: Randomised comparison of two doses
title_short Effect of caudal clonidine on emergence agitation and postoperative analgesia after sevoflurane anaesthesia in children: Randomised comparison of two doses
title_sort effect of caudal clonidine on emergence agitation and postoperative analgesia after sevoflurane anaesthesia in children: randomised comparison of two doses
topic Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296357/
https://www.ncbi.nlm.nih.gov/pubmed/25624536
http://dx.doi.org/10.4103/0019-5049.147163
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