Can a dose of 2microg.kg(-1) caudal clonidine cause respiratory depression in neonates?
A case of multiple life-threatening postoperative apnoeas in a term neonate undergoing inguinal herniorrhaphy and orchidopexy who received light inhalation anaesthesia combined with caudal block with 1 ml.kg-1 ropivacaine 0.2% plus 2 microg.kg-1 clonidine is reported. The patient showed no apparent risk factors for postanaesthetic apnoea. Oxycardiorespirography five days after surgery only showed minor abnormalities. Clonidine though administered caudally in the usual dose of 2 microg.kg-1 appeared to be the most likely cause for postanaesthetic apnoea in this neonate.
Breschan
C
C
Department of Anaesthesia, LKH Klagenfurt, Austria; Department of Paediatrics, Neonatal Intensive Care Unit, LKH Klagenfurt, Austria.
Krumpholz
R
R
Likar
R
R
Kraschl
R
R
Schalk
H V
HV
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D000577:Amides / Q000008:administration & dosage; D000763:Anesthesia, Caudal / Q000009:adverse effects*; D000769:Anesthesia, Inhalation; D000779:Anesthetics, Local / Q000008:administration & dosage; D001049:Apnea / Q000139:chemically induced*; D001919:Bradycardia / Q000139:chemically induced; D003000:Clonidine / Q000008:administration & dosage / Q000009:adverse effects*; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications / Q000139:chemically induced*; D012119:Respiration / Q000187:drug effects; D012307:Risk Factors; D000077212:Ropivacaine; D013737:Testis / Q000601:surgery
D000316:Adrenergic alpha-Agonists; D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D003000:Clonidine; D010100:Oxygen