Analgesic Effect of Caudal Bupivacaine with or without Clonidine in Pediatric Patient

Khakurel, Sharad; Sapkota, Shanta; Karki, Anuj Jung

doi:10.33314/jnhrc.v16i41.1647

Cited by 5 publications

(3 citation statements)

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“…Clonidine is a high blood pressure medication that can affect the alpha-adrenergic receptors and imidazoline as an agonist [ 54 ]. A critical theory about the effect mechanisms of clonidine in pain management describes that many pain signals are generated in the dorsal horn of the spinal cord and then sent to the central nervous system.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of oral clonidine and gabapentin on peripheral neuropathy in diabetic patients in southwestern Iran: a randomized clinical trial

Hassanzadeh,

Bagheri,

Majid Ahmadi

et al. 2023

BMC Endocr Disord

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Background Peripheral neuropathy is not only the most prevalent consequence of diabetes but also the main reason for foot ulceration, disability, and amputation. Therefore, the current study aims to determine the effectiveness of oral clonidine and gabapentin on peripheral neuropathy in diabetic patients. Methods This 12-week, randomized, and parallel-group trial was conducted to compare the efficacy of oral clonidine and gabapentin with gabapentin alone in diabetic patients in southwest Iran during the first half of 2021. Thirty patients with type 2 diabetes with peripheral neuropathy as assessed by a visual analog scale (VAS) and divided into two groups of 15 patients, treated for up to three months. The data were analyzed using SPSS-21 software. In order to report the results, descriptive indices, independent t-test, one-way analysis of covariance (ANCOVA) and analysis of variance with repeated measures were used. Results The mean and standard deviation of the age of the participants in the clonidine + gabapentin group was equal to 50.20 ± 7.44, and in the gabapentin group was equal to 50.47 ± 7.57 (t = 0.10, P-value = 0.923). This research showed a significant difference between the clonidine + gabapentin group and with gabapentin group in terms of neuropathic pain and the severity of neuropathic pain (P < 0.001). Conclusions According to this research results, clonidine + gabapentin can reduce neuropathic pain and the severity of neuropathic pain in diabetic patients. Therefore, it is recommended that healthcare professionals with diabetes expertise prescribe these medications to reduce neuropathic pain and its severity. Trial registration This study was registered in the Iranian Clinical Trials System with the ID (IRCT20211106052983N1) on 14/01/2022.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of oral clonidine and gabapentin on peripheral neuropathy in diabetic patients in southwestern Iran: a randomized clinical trial

Hassanzadeh,

Bagheri,

Majid Ahmadi

et al. 2023

BMC Endocr Disord

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“…15 Single-shot caudal block, which once used to be very popular, is now losing its popularity in clinical practice due to its relative shorter duration of action, for which several additive drugs are now being used to enhance the Bupivacaine caudal block analgesia duration. 16 Caudal block is also associated with local and systemic side effects, including ascending meningitis, arrhythmias, hypotension, seizures, puncture site infection, osteomyelitis of sacral bone, block failure, and local nerve root injury. 17 Splinter et al, performed a study to compare the effect of local anaesthesia with caudal anaesthesia on post-operative care of children undergoing inguinal hernia repair.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Bupivacaine Wound Infiltration with Bupivacaine Caudal Block on Postoperative Pain in Pediatric Open Inguinal Herniotomy

Saleem

Riaz

et al. 2022

PAFMJ

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Objective: To compare the effectiveness of Bupivacaine local wound infiltration with Bupivacaine caudal block on postoperative pain in children undergoing open inguinal hernia repair. Study Design: Quasi-experimental study. Place and Duration: Department of Paediatric Surgery, Pak Emirates Military Hospital Rawalpindi, from Jan to Sep 2019. Methodology: 60 patients (30 each in two groups) fulfilling the inclusion criteria who underwent open inguinal herniotomy were included in this study. Patients in group-A received caudal block with 0.25% Bupivacaine 1 ml/kg body weight, while Group-B received local wound infiltration of 0.5% Bupivacaine 2 mg/kg body weight after the completion of surgery. The post-operative pain score was calculated using Hannallah's objective pain scale at 30 minutes, one, two, four, six and eight hours following the procedure. A total pain score of 3 requiring the rescue analgesia in the form of oral Paracetamol (10 mg/kg body weight) was considered the endpoint. Results: Mean post-operative pain score was 8.20 ± 1.54 in group-A compared to 7.20 ± 1.88 in Group-B with the p-value of 0.02, which showed a statistically significant difference between the two groups. Conclusion: We concluded that local infiltration with Bupivacaine after open herniotomy in children is safe, highly effective and easy to perform the procedure, which results in excellent post-operative analgesia compared to caudal Bupivacaine block.

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“…Ketamine, Fentanyl, and Clonidine mixed with caudal LA have been studied for prolonging postoperative analgesia in children. 1,5,6 Despite efficacy, opioids including Fentanyl and Morphine are not universally accepted owing to their higher association with itching, vomiting, and hypoventilation. 1,7,8 Dexmedetomidine, a newer alpha-2 adrenergic receptor agonist that possesses a better receptor selectivity when compared to Clonidine, is shown to prolong the action of caudal LA.…”

Section: Introductionmentioning

confidence: 99%

Study of Dexmedetomidine in Caudal Block for Children Undergoing Inguino-scrotal Surgery

Gautam¹,

Piya²,

Karki³

2020

Kathmandu Univ. Med. J.

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Background Caudal block is the most common anaesthetic technique employed in children for managing perioperative pain of inguino-scrotal surgery. However, despite using long-acting local anaesthetics, caudal analgesia lasts relatively shorter. Dexmedetomidine, an alpha-2 agonist, augments local anaesthetic action. Objective To assess the analgesic effect of caudal Dexmedetomidine. Method This is a randomized, double-blinded study conducted on otherwise healthy children (one to five years) undergoing elective inguino-scrotal surgery. General anaesthesia was administered and a laryngeal mask airway was inserted for assisting ventilation. The caudal block was applied using 0.8 milliliters/kilogram drug volume comprising either two milligrams/kilogram Bupivacaine in group A (n=42) or two milligrams/ kilogram Bupivacaine mixed with 0.75 micrograms/kilogram Dexmedetomidine in group B (n=42). Intraoperatively, inhaled Halothane, intravenous Fentanyl, fluids, and ventilation were titrated to maintain monitored hemodynamic variables within 15% from baseline values. The primary endpoint comprised the duration of analgesia, defined by a time when postoperative pain score (face, legs, activity, cry, consolability; FLACC scale) reached four out of ten. Perioperative events were studied for 24 hours. Student’s t-test and Chi-square test were used for analysis, with p-value less than 0.05 considered as significant. Result Demographic, surgical, and anaesthetic characteristics were similar between the groups. Duration of analgesia was significantly prolonged in group B (group B, 413±101 minutes; group A, 204±40 minutes). The intraoperative requirement for supplement Fentanyl was significantly reduced in group B. Adverse events were comparable between the groups. Conclusion Dexmedetomidine prolongs the duration of analgesia when mixed with caudal Bupivacaine, without increasing adverse events.

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Analgesic Effect of Caudal Bupivacaine with or without Clonidine in Pediatric Patient

Cited by 5 publications

References 0 publications

Effectiveness of oral clonidine and gabapentin on peripheral neuropathy in diabetic patients in southwestern Iran: a randomized clinical trial

Effectiveness of oral clonidine and gabapentin on peripheral neuropathy in diabetic patients in southwestern Iran: a randomized clinical trial

Comparison of Bupivacaine Wound Infiltration with Bupivacaine Caudal Block on Postoperative Pain in Pediatric Open Inguinal Herniotomy

Study of Dexmedetomidine in Caudal Block for Children Undergoing Inguino-scrotal Surgery

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