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[Spinal anesthesia in children: comparative study of hyperbaric bupivacaine with or without clonidine]
O Kaabachi1, A Ben Rajeb, M Mebazaa
1Service d'orthopédie, hôpital d'enfants de Tunis, 1007 Tunis, Tunisie. olfa.kaabachi@rns.tn
Insights
Intrathecal clonidine in children significantly prolonged postoperative analgesia but increased side effects like hypotension and bradycardia. Further research is needed to balance benefits and risks.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
Background:
- Intrathecal anesthesia is common in pediatric surgery.
- Clonidine is an alpha-2 adrenergic agonist with potential analgesic properties.
Purpose of the Study:
- To investigate the efficacy and safety of intrathecal clonidine in pediatric patients undergoing surgery.
Main Methods:
- A prospective randomized study involving 45 children aged 6-15 years.
- Children received either bupivacaine or bupivacaine with clonidine (2 mcg/kg).
- Evaluated motor/sensory block characteristics and side effects (hypotension, bradycardia, sedation).
Main Results:
- Clonidine significantly extended postoperative analgesia duration (490 vs. 200 minutes, p < 0.001).
- Motor block prolongation was observed but not statistically significant (190 vs. 150 minutes).
- Higher incidence of hypotension (54% vs. 36%) and bradycardia (30% vs. 0%) in the clonidine group.
Conclusions:
- Intrathecal clonidine at 2 mcg/kg effectively prolongs postoperative analgesia in children.
- The benefits of extended analgesia must be weighed against increased risks of hypotension and bradycardia.
Objective:
To evaluate the effect of intrathecal clonidine in children.
Study Design:
A prospective randomised study.
Patients And Methods:
45 children, 6 to 15 years old, were randomised in two groups; receiving either 0.5% hyperbaric bupivacaine or 0.5% hyperbaric bupivacaine added to clonidine 2 micrograms.kg-1. We assessed quality and length of motor and sensory blocks and side effects of clonidine: hypotension, bradycardia and sedation.
Results:
Clonidine was associated with prolongation of motor block. 190 +/- 42 min vs 150 +/- 35 min (p < 0.01), but the difference was not significant. Postoperative analgesia was longer in clonidine group, 490 +/- 35 min vs 200 +/- 50 min (mean +/- SD), p < 0.001. Clonidine was associated with higher incidence of hypotension 54 vs 36% and bradycardia 30 vs 0%.
Conclusion:
These data suggest that intrathecal clonidine 2 micrograms.kg-1 is associated with extending duration of postoperative analgesia but with moderate side effects.