Comparati Ive study of caudal Clonidiine with ketamine added to ropivacaine in pediatrics for below umbilical surgeries

Dr. Ankita Nathani, D. S. Kulkarni, Dr. Vasanti Kelkar, Dr. Pradnya S Joshi
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Abstract

Aims: The purpose of our study was to compare the efficacy and safety of Clonidine to that of Ketamine added to 0.25% ropivacaine for caudal analgesia in children. Settings and Design: prospective, double blind randomized controlled trial. Material and Methods: Sixty children in the age group of 1 – 8 years undergoing sub umbilical surgeries were included in the study. After induction with general anaesthesia, caudal block was given with injection Ropivacaine 0.25% 1ml/kg and Clonidine 1µg/kg in group RC and injection Ropivacaine 0.25% 1 ml/kg and Ketamine 0.5 mg/kg in group RK. Results: The mean duration of analgesia was 530±44.2 mins in RC group as compared to 395±43.4 mins in RK group. The duration of analgesia was significantly prolonged in group RC with p value of 0.000. The mean pain score of RK group was higher than RC group at 6 th (3.5±0.57 vs. 3.0±0.37) and 8 th hour (3.93±0.25vs3.63±0.49) postoperatively which was statistically significant. There was no significant difference between the two groups with respect to haemodynamic parameters as only one patient had bradycardia in RC group. Conclusion: Ropivacaine (0.25%) with Clonidine (1µg/kg) in caudal block significantly prolongs the duration of analgesia compared to Ropivacaine (0.25%) with Ketamine (0.5mg/kg), without any adverse effects, can be used safely in paediatric caudal block.
小儿脐下手术中氯胺酮与氯胺酮加罗哌卡因的比较研究
目的:比较可乐定与氯胺酮加0.25%罗哌卡因用于小儿尾侧镇痛的疗效和安全性。设定与设计:前瞻性、双盲、随机对照试验。材料与方法:选取60例年龄在1 ~ 8岁之间接受脐下手术的儿童作为研究对象。全麻诱导后,RC组注射罗哌卡因0.25% 1ml/kg、可乐定1µg/kg, RK组注射罗哌卡因0.25% 1ml/kg、氯胺酮0.5 mg/kg,给予尾侧阻滞。结果:RC组平均镇痛时间为530±44.2 min, RK组平均镇痛时间为395±43.4 min。RC组镇痛时间明显延长,p值为0.000。RK组术后6 h(3.5±0.57 vs 3.0±0.37)和8 h(3.93±0.25vs3.63±0.49)的平均疼痛评分高于RC组,差异有统计学意义。两组在血流动力学参数方面无显著差异,RC组仅有1例患者出现心动过缓。结论:与罗哌卡因(0.25%)与氯胺酮(0.5mg/kg)联合应用相比,罗哌卡因(0.25%)与氯胺酮(1µg/kg)联合应用于小儿尾侧阻滞可显著延长镇痛时间,且无不良反应,可安全应用于小儿尾侧阻滞。
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