title: Efficacy of clonidine as an adjuvant to ropivacaine for caudal analgesia in children undergoing subumbilical surgery.
abstract: BACKGROUND
  The use of clonidine as an adjuvant to ropivacaine in different concentrations through the caudal space has been shown to improve the analgesic efficacy of local anesthetics.
  
  
  OBJECTIVE
  The purpose of our study was to compare the efficacy of ropivacaine 0.1% with clonidine 1 mcg/kg to that of plain 0.1% and 0.2% ropivacaine for caudal analgesia in children.
  
  
  METHODS
  Prospective, double blind, randomized controlled trial.
  
  
  METHODS
  Sixty children in the age group of 1-6 years undergoing subumbilical surgeries were included in the study. Group A received 1 ml/kg of 0.1% ropivacaine, group B received 1 ml/kg of 0.1% ropivacaine with clonidine 1 mcg/kg, and group C received 1 ml/kg of 0.2% ropivacaine.
  
  
  RESULTS
  The mean duration of analgesia was 243.7 ± 99.29 min in group A, 590.25 ± 83.93 min in group B, and 388.25 ± 82.35 min in group C. The duration of analgesia was significantly prolonged in group B compared to groups A and C with the P value of 0.001. At 8 h, all the 20 children in group A had received the first rescue analgesic compared to 18 children in group C and 3 children in group B. The duration of motor blockade after extubation was 30.6 ± 7.8 min and was noted only in group C. Only 1 child in group B received two rescue medications compared to 15 (75%) children in group A and 8 (40%) children in group C. None of the groups were treated for bradycardia or hypotension and no significant sedation was noted.
  
  
  CONCLUSIONS
  Clonidine 1 mcg/kg with ropivacaine 0.1% prolongs the duration and quality of analgesia compared to plain ropivacaine 0.1% and 0.2% without any significant sedation.
authors.affiliation: Department of Anesthesiology Critical Care and Pain Medicine, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India.
authors.forename: Akilandeswari
authors.initials: A
authors.lastname: Manickam
authors.forename: Mahesh
authors.initials: M
authors.lastname: Vakamudi
authors.forename: Aruna
authors.initials: A
authors.lastname: Parameswari
authors.forename: Chetana
authors.initials: C
authors.lastname: Chetan