Comparison of the Efficacy of Ropivacaine-Clonidine Mixture with Plain Ropivacaine for Caudal Analgesia in Paediatric Lower Abdominal Surgeries

BACKGROUND Caudal epidural is practised in paediatric anaesthesia with the aim of providing postoperative analgesia. To use clonidine as an adjuvant to ropivacaine through caudal space has been shown to improve analgesic efficacy of local anaesthetics. We wanted to evaluate postoperative caudal analgesia with 0.2% ropivacaine alone and its combination with clonidine. METHODS 120 children aged between two to eight years scheduled for lower abdominal surgeries were allocated randomly into two groups. Group RO received 0.2% ropivacaine 1 mL/Kg and Group RO C received 0.2% ropivacaine 1 mL/Kg with clonidine in a dose of 2 µg/Kg. Postoperative pain was assessed using the observational pain discomfort scale (OPS) for 24 hours and rescue analgesia was administered if this score reached 11 or more. RESULTS The duration of analgesia was longest in children receiving clonidine and ropivacaine together (380.71 minutes vs. 270 minutes group RO) and was found to be statistically significant; P ˂ 0.05. Significantly fewer doses of rescue medications were needed for subjects in group RO C. None of the subjects were treated for bradycardia or hypotension and no significant sedation was noted. No motor impairment was seen in either groups on awakening or during the next 24- hour period. CONCLUSIONS Caudal administration of ropivacaine with the addition of clonidine resulted in superior analgesia with longer duration with decreased demand for rescue analgesics.