Prospective to a randomized double-blind controlled trial to assess efficacy of double caudal analgesia in hypospadias repair

Samuel, Madan; Hampson-Evans, D.; Cunnington, Pmd

doi:10.1053/jpsu.2002.30247

Cited by 28 publications

(23 citation statements)

References 11 publications

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“…[78] The limitation of the single shot caudal blockade is its finite and short duration, which reduces its utility as post-operative analgesic. To overcome this shortcoming, a trial was done with double caudal technique, but it was not found to be safe due to concern of toxicity from high volume[9] Therefore, there is a continuous search for an ideal adjuvant to prolong the duration of analgesia.…”

Section: Discussionmentioning

confidence: 99%

Comparison of caudal analgesia between ropivacaine and ropivacaine with clonidine in children: A randomized controlled trial

2012

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Background:Addition of clonidine to ropivacaine (0.2%) can potentially enhance analgesia without producing prolonged motor blockade. The aim of the present study was to compare the post-operative pain relieving quality of ropivacaine 0.2% and clonidine mixture to that of plain ropivacaine 0.2% following caudal administration in children.Methods:In a prospective, double-blinded, randomized controlled trial, 30 ASA 1 pediatric patients undergoing infraumbilical surgery were randomly allocated to receive a caudal injection of either plain ropivacaine 0.2% (1 ml/kg) (group A) or a mixture of ropivacaine 0.2% (1 ml/kg) with clonidine 2 μg/kg (group B). Objective pain score and need for supplemental analgesics were compared during the 1st 24 hours postoperatively. Residual post-operative sedation and motor blockade were also assessed.Results:Significantly prolonged duration of post-operative analgesia was observed in group B (P<0.0001). Heart rate and blood pressure were not different in 2 groups. Neither motor blockade nor post-operative sedation varied significantly between the groups.Conclusion:The combination of clonidine (2 μg/kg) and ropivacaine 0.2% was associated with an improved quality of post-operative analgesia compared to plain 0.2% ropivacaine. The improved analgesic quality of the clonidine-ropivacaine mixture was achieved without causing any significant degree of post-operative sedation or prolongation of motor blockade.

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Section: Discussionmentioning

confidence: 99%

Comparison of caudal analgesia between ropivacaine and ropivacaine with clonidine in children: A randomized controlled trial

2012

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“…The recent literature has cited the double-caudal technique whereby topped up caudal solution is injected at the end of surgery but its popularity is still limited on the grounds of toxicity due to large volume of drugs injected. [2]…”

Section: Introductionmentioning

confidence: 99%

Caudal ropivacaine-clonidine: A better post-operative analgesic approach

Bajwa¹,

Kaur²,

Bajwa³

et al. 2010

Indian J Anaesth

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The aim was to determine qualitative and quantitative aspects of caudal block, haemodynamic effects, and post-operative pain relief of ropivacaine 0.25% versus ropivacaine 0.25% with clonidine for lower abdominal surgeries in paediatric patients. A double-blind study was conducted among 44 paediatric patients in the Department of Anaesthesiology and Intensive Care of our institute. A total of 44 ASA-I paediatric patients between the ages of 1 and 9 years, scheduled for elective hernia surgery, were enrolled in this randomised double-blind study. The caudal block was administered with ropivacaine 0.25% (Group I) and ropivacaine 0.25% and clonidine 2 µg/kg (Group II) after induction with general anaesthesia. Haemodynamic parameters were observed before, during and after the surgical procedure. Post-operative analgesic duration, total dose of rescue analgesia, pain scores and any side effects were looked for and recorded. All the results were tabulated and analysed statistically. The variables in the two groups were compared using the non-parametric tests. For all statistical analyses, the level of significance was P < 0.05. Forty-four patients were enrolled in this study and their data were subjected to statistical analysis: 22 patients in both the groups were comparable with regard to demographic data, haemodynamic parameters and other vitals and were statistically non-significant (P>0.05). The duration of analgesia was significantly prolonged in Group II (P<0.05). The dose requirement for post-operative pain relief was also significantly lesser in Group II. The incidences of side effects were almost comparable and non-significant. A caudal block with 0.25% of isobaric ropivacaine combined with 2 µg/kg of clonidine provides efficient analgesia intra-operatively and prolonged duration of analgesia post-operatively.

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“…Caudal block combined with general anesthesia enable pediatric surgeon and pediatric urologist to perform day case surgery more effectively [12,13]. Because it decreases per operative inhalation anesthetic doses, and provide better postoperative pain control.…”

Section: Discussionmentioning

confidence: 99%

Caudal Block with General Anesthesia for Outpatient Pediatric Surgery Procedures

İrşi

Arzu

Firdevs

2017

JACCOA

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Background: Pediatric surgery is mostly done in an outpatient setting and due to this fact preoperative and postoperative pain management is a very important task to overcome. Aim:We aim to share and underline our clinical experience regarding with the children's comfort and parents' satisfaction after outpatient pediatric surgery cases performed under general anesthesia combined with caudal block regional anesthesia. Methods:The files of 405 ASA1 outpatient pediatric surgery patients were retrospectively reviewed. Each inguinoscrotal procedures performed under general anesthesia combined with caudal extradural 1ml/kg bupivacaine. Caudal extradural block was performed just after general anesthesia induction just before the operation. The objective pain score was used to determine child analgesia requirement level postoperatively up to 12 hours. Postoperative pain control was sustained for 48 hours using routine paracetamol and ibuprofen if needed.Results: Combined anesthesia and caudal block during outpatient procedures leads usage of low dose of inhalation anesthetic requirement and early recovery from the anesthetic condition. This was achieved by effective pain control of caudal block. The main concentration of caudal block performed according to the types of outpatient procedures. In hypospadias patient bupivacaine concentration were kept at high level aim to prolong lower extremities immobilization for better recovery. Combined anesthesia with caudal block for outpatient procedures made possible to discharge all most all of the patients as day case surgery. Conclusion:Combined general anesthesia with caudal analgesia with bupivacaine enable us effective and safe per operative pain control beside usage of lower dose of inoperative anesthetic agents makes day case surgery more safer for children with less side effects.

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Prospective to a randomized double-blind controlled trial to assess efficacy of double caudal analgesia in hypospadias repair

Cited by 28 publications

References 11 publications

Comparison of caudal analgesia between ropivacaine and ropivacaine with clonidine in children: A randomized controlled trial

Comparison of caudal analgesia between ropivacaine and ropivacaine with clonidine in children: A randomized controlled trial

Caudal ropivacaine-clonidine: A better post-operative analgesic approach

Caudal Block with General Anesthesia for Outpatient Pediatric Surgery Procedures

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