Background: Caudal analgesia has long been the cornerstone to successful pain management in children undergoing abdominal and lower limb surgeries. Its analgesic duration with single shot injection is however limited. So adjuvants are used with local anesthetics in an attempt to increase the duration of caudal analgesia. This study aims to investigate the duration of analgesia provided by Clonidine when added to caudal Bupivacaine.Methods: A randomized, double blinded, comparative study was conducted on 64 patients, aged two to seven years, scheduled for unilateral inguinal hernia repair. Patients were randomly allocated into two groups of 32 each, with group A receiving bupivacaine two milligram/kilogram and group B receiving bupivacaine two milligram/kilogram with one microgram/kilogramclonidine, (total volume of injectate was one milliliter/kilogram). Duration of analgesia, hemodynamic response and adverse effects, if any were noted.Results: Mean duration of analgesia in group A was 264.12 ± 68.77 minutes and in group B was 520 ± 57.37 minutes, p-value <0.001.Incidence of vomiting was 9% in group A compared to 6% in group B.Conclusions: Clonidineas an adjuvant to caudal bupivacaine prolongs the duration of analgesia without increasing the adverse effects.Keywords: Bupivacaine; caudal analgesia; clonidine;pediatric.
Subarachnoid block is a safe and effective regional anesthesia technique. It is usually carried out in sitting or lateral position but it can also be performed in prone position. Here we report two cases of flame burn over bilateral gluteal region extending to the posterior and lateral aspect of both thighs, who were planned for debridement and split skin grafting. Both patients had difficulty in siting and lying on either side of lateral position. We had administered subarachnoid block in prone position taking into consideration of patient’s comfort and the nature of the procedure. Both patients remained hemodynamically stable throughout the procedure and their post-operative periods were uneventful.Keywords: Burn; prone position; subarachnoid block
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