title: Transcutaneous CO2 tension effects of clonidine in paediatric caudal analgesia.
abstract: In adults, clonidine when added to bupivacaine, results in no detectable respiratory depressant effect except when carbon dioxide challenge is performed. However, to date no investigations have quantified this in children. Twenty-four children (nine months to seven years) were randomized in a double-blind study into two groups. After induction, a caudal block was performed with 1 ml.kg-1 0.25% bupivacaine. Clonidine 1 microgram.kg-1 was added in the clonidine group, and 1 ml normal saline in the placebo group. Patients were monitored in the recovery room for three h from arrival to discharge with continuous pulse oximetry, respiratory rate, a transcutaneous CO2 tension (tcPCO2) every 15 min, and a four point sedation score every 30 min. Mean tcPCO2 and respiratory rate values were not different between the two groups. Apnoea and desaturation less than 97% were not observed. The sedation score decreased with time in both groups, and the score time interval was significantly higher in the clonidine group (P < 0.05). All the patients left the recovery room with a sedation score of 1, excepting four in the clonidine group with a sedation score of 2. Clonidine 1 microgram.kg-1 with 0.25% bupivacaine mixture in caudal analgesia in children did not induce an increase in tcPCO2 despite prolonged sedation.
authors.affiliation: Department of Anesthesiology and Intensive Care Medecine, Hôpital de Bicêtre, Université Paris-Sud, Le Kremlin Bicêtre, France.
authors.forename: A
authors.initials: A
authors.lastname: Dupeyrat
authors.forename: E
authors.initials: E
authors.lastname: Goujard
authors.forename: J
authors.initials: J
authors.lastname: Muret
authors.forename: C
authors.initials: C
authors.lastname: Ecoffey
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000494:pharmacology*; D015360:Analgesia, Epidural; D000769:Anesthesia, Inhalation; D000779:Anesthetics, Local; D001785:Blood Gas Monitoring, Transcutaneous; D002045:Bupivacaine; D002245:Carbon Dioxide / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003000:Clonidine / Q000494:pharmacology*; D004311:Double-Blind Method; D006801:Humans; D007223:Infant; D010092:Oximetry; D010149:Postoperative Pain; D012119:Respiration / Q000187:drug effects
chemical_list: D000316:Adrenergic alpha-Agonists; D000779:Anesthetics, Local; D002245:Carbon Dioxide; D003000:Clonidine; D002045:Bupivacaine