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

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.