Addition of Clonidine in Caudal Anesthesia in Children Increases Duration of Post-Operative Analgesia

Lak, Marzieh; Araghizadeh, H; Shayeghi, Shahnas; Khatibi, Behroz

doi:10.5812/kowsar.22517464.3393

Cited by 4 publications

(2 citation statements)

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“…In conclusion 75 µg clonidine plus bupivacaine may increase the duration of motor and sensory block in arthroscopic cruciate ligament repair under spinal anesthesia, and decrease consumption of analgesics. Considering the higher incidence of BP drop in our study compared to previous reports ( 5 - 20 ), further studies are required to determine the safe dose of clonidine. This drug combination is suitable for long-duration surgeries due to the increased duration of motor block and analgesia.…”

Section: Discussionmentioning

confidence: 60%

Effect of Addition of Clonidine to Bupivacaine in Spinal Anesthesia on Analgesia After Cruciate Ligament Repair: A Randomized Double-Blinded Clinical Trial

et al. 2015

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Background:Several researchers have suggested that addition of local anesthetics to spinal anesthesia increases the duration of post-operative analgesia.Objectives:This study sought to assess the effect of addition of clonidine to bupivacaine in spinal anesthesia on analgesia after cruciate ligament repair.Patients and Methods:This double-blind clinical trial was conducted on 50 American Society of Anesthesiologists (ASA) class I or II patients who were candidates for cruciate ligament repair. Patients were randomly assigned to two groups; one group received 15 mg of bupivacaine (group B) and the other 15 mg of bupivacaine plus clonidine (75 µg, group BC). The two groups were compared in terms of post-operative analgesia and related factors using the SPSS software version 20.Results:All patients were males with a mean age of 24.9 years in group B, and 25.2 years in group BC (P > 0.05). In group BC, time lapse to request analgesics was 160 minutes longer and the Visual Analog Scale (VAS) at this time was 0.3 units less than group B. The time to regression of sensory block by two dermatomes was seven minutes longer, VAS in the recovery room was 1 unit less and Bromage scale in the recovery room and ward was 0.6 and 0.9 units more, respectively in the BC group. Hypotension and ephedrine usage was 36% more in the BC group (P < 0.05).Conclusions:Clonidine plus bupivacaine can increase the duration of motor and sensory block in arthroscopic cruciate ligament repair under spinal anesthesia. However, due to significant hemodynamic changes, further studies are required to determine a safer dose.

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Section: Discussionmentioning

confidence: 60%

Effect of Addition of Clonidine to Bupivacaine in Spinal Anesthesia on Analgesia After Cruciate Ligament Repair: A Randomized Double-Blinded Clinical Trial

et al. 2015

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“…Consequently, inappropriate pain management can influence the child's morbidity and mortality [1]. Owing to a better understanding of the neurobiology of pain in the past three decades, it has been observed that pain managing practice that use one type of pain reliever to control one of the pain pathways are usually less effective compared to those that use a combination of analgesics that control multiple pathways [2]. Postoperative pain causes harmful effects like variations in hemodynamic parameters in the form of rising in blood glucose, behavioral and neuroendocrine stress response in the form of increased cortisol levels, catecholamines and growth hormone [3,4].…”

Section: Introductionmentioning

confidence: 99%

A comparative study of Fentanyl and Clonidine as additives to plain Bupivacaine in caudal anaesthesia in children

et al. 2017

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Introduction: The efficacy of clonidine or fentanyl as additives to alter the neuroendocrine stress response and emergence agitation in caudal anaesthesia in children is still not clear. Objectives: To compare the efficacy and safety of Fentanyl and Clonidine as additives to plain bupivacaine in caudal anaesthesia in children. Materials & Methods: A prospective, open labeled randomized controlled trial was conducted in Meenakshi Mission Hospital and Research Centre, Madurai, between August 2008 to June 2010. Children undergoing various elective infra-umbilical surgical procedures were included. Children were randomly assigned to either 0.5% Bupivacaine(B), Fentanyl plus 0.5% Bupivacaine (BF) or Clonidine Plus 0.5% Bupivacaine (BC) groups. Results: A total of 90 children, with 30 subjects in each of the three intervention groups were included. Time taken for spontaneous movement was significantly higher (151.8±11.7) in BC group, as compared the other two groups. The duration of postoperative analgesia was lowest in Bupivacaine (146±91.2) alone group, followed by BF (293.5±154.5) and BC group (510±359.9). Sedation time also has shown a similar trend. The mean pain scores from 2 hours to 24 hours were highest in bupivacaine group, followed by BF and BC group. The differences in the sedation scores across the three study groups from 45minutes to 24-hour postoperative period were statistically significant. Conclusions: Addition of clonidine 1µg/kg to 0.5% bupivacaine prolonged the duration of postoperative analgesia after a single shot caudal injection without any significant side effects when compared to bupivacaine 0.5% alone or its combination with fentanyl 1µg/kg.

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Quality Assessment of Published Randomized, Controlled Trials in Trauma Monthly Journal

Salesi¹,

Rasouli²,

Mohammadi³

et al. 2017

Trauma Mon

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Context: Randomized controlled trials (RCTs) have a major role in making the evidence-based decisions on healthcare. Therefore, the assessment of the quality of RCTs is important to properly apply the evidence-based healthcare. The current study aimed at assessing the quality of RCT reports published in Trauma Monthly Journal. Evidence Acquisition: The quality assessment of each report was performed using a checklist based on the CONSORT (consolidated standards of reporting trials) Statement and Jadad criteria. Results: Fifteen RCTs were published from 2011 to 2015 in Trauma Monthly journal out of which 5 (33.3%) reported the pain outcomes, 7 (46.6%) reports included surgical interventions, and 3 (33.3%) reports included patients with different types of fractures. According to the CONSORT checklist, the best report belonged to the definition of interventions for each group with sufficient details. The mean score of Jadad was 2.27 (45.4% of maximum possible total score). According to both scales, there was an increase in the periods of time in the quality of reporting. Conclusions:The results showed a moderate quality score in RCTs and a minor improvement over the years. Training courses for researchers, managing reporting standard tools presented by editors (CONSORT checklist) and employing methodologists and statistical experts can develop the quality of published RCTs.Keywords: Quality Assessment, Randomized Controlled Trial, Checklist, Trauma Context Quality Assessment of Randomized Controlled TrialsRCTs are often performed to assess the effect of new treatments and are considered evidence-based for clinical trials (1). Therefore, it is of paramount importance to design and report high-quality RCTs. Also, for proper use and exploration of the evidence-based approach, it is important and necessary to assess the quality of RCTs.The quality of a trial was explained by the validity and accuracy of analysis and design. But, the quality of reporting was explained as reporting characteristics about the analysis and design of the RCT (2).There are various approaches to assess the quality of RCTs. It is usually performed using 3 tools of the component, checklist, and scale.Also, the quality of RCTs was evaluated in the metaanalysis studies. The CONSORT (consolidated standards of reporting trials) guidelines and Jadad criteria are often used in meta-analysis studies. Recently, to integrate the results of RCTs, meta-analyses are conducted increasingly (3, 4). Therefore, there is a great interest to evaluate the quality of RCTs to include them in the meta-analyses (5-7). Therefore, since the quality of trials affect the results of meta-analyses, results may be less valuable if the quality of RCTs is not assessed (2). To achieve the valuable results of a trial, the quality of RCT is very important.It is recommended that journals implement more CONSORT guidelines (8). The works should be complete and clear before publishing.However, RCTs are increasingly published in journals (9). It is important for the promotion ...

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Addition of Clonidine in Caudal Anesthesia in Children Increases Duration of Post-Operative Analgesia

Cited by 4 publications

References 14 publications

Effect of Addition of Clonidine to Bupivacaine in Spinal Anesthesia on Analgesia After Cruciate Ligament Repair: A Randomized Double-Blinded Clinical Trial

Effect of Addition of Clonidine to Bupivacaine in Spinal Anesthesia on Analgesia After Cruciate Ligament Repair: A Randomized Double-Blinded Clinical Trial

A comparative study of Fentanyl and Clonidine as additives to plain Bupivacaine in caudal anaesthesia in children

Quality Assessment of Published Randomized, Controlled Trials in Trauma Monthly Journal

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