Comparative study of post-operative caudal analgesia for paediatric patients undergoing lower abdominal surgery

Author: 
Shashank Kumar Kanaujia., Ajay Kumar Chaudhary., Prithvi Kumar Singh., Brij Bihari Kushwaha., Radhey Shyam., Dinesh Singh., Girish Chandra and Vinod Kumar Bhatia

Background Caudal epidural analgesia is commonly used in pediatric anesthesia. It is a safe and reliable technique that can be used with general anesthesia for perioperative analgesia in patients undergoing abdominal surgeries. The aim of the study to evaluate quality and duration of analgesia with various dosages of clonidine with levobupivacaine as an adjuvant.

Method Ninty children, age one to nine years, undergoing lower abdominal surgery, were comprises to three groups: caudal analgesia with 1 ml/kg of 0.25% levobupivacaine in normal saline (group I), 1 ml/kg of 0.25% levobupivacaine with 0.8 µg/kg of clonidine (group II) and 1 ml/kg of 0.25% levobupivacaine with 1.0 µg/kg of clonidine (group III). Post-operative pain was assessed by FLACC scale for 15 hours.

Result Pain of children was assessed on the Face, Legs, Activity, and Cry, FLACC scale. At 15 min. after the procedure score of all the subjects in Group I, Group II and Group III was found to be '0'. The score remained '0' at all time intervals up to 2 and 4 hours FLACC score. The difference in FLACC score among the groups was found to be statistically significant. Between group differences were found to be statistically significant between Group I & Group II and between Group II & Group III. No difference in FLACC score of Group I and Group III was found.

Conclusion Clonidine in a dose of 1 µg/kg added to 0.25% levobupivacaine for caudal analgesia, during lower abdominal surgeries, prolongs the duration of analgesia, and reduced the rescue analgesia without any adverse effects.

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