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Randomized controlled trial comparing morphine or clonidine with bupivacaine for caudal analgesia in children

R Singh1, N Kumar, P Singh

  • 1Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.

British Journal of Anaesthesia
|October 19, 2010
PubMed

Insights

Caudal clonidine extended analgesia duration in children undergoing abdominal surgery compared to morphine. Clonidine provided longer pain relief and sedation with fewer side effects.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pharmacology

Background:

  • Bupivacaine is used for caudal analgesia in children.
  • Additives are explored to prolong bupivacaine's analgesic effects.

Purpose of the Study:

  • To compare the efficacy of caudal clonidine versus morphine as additives to bupivacaine for analgesia in pediatric patients undergoing upper abdominal surgery.

Main Methods:

  • A prospective, randomized, double-blind study involved 50 children (1-6 years) undergoing upper abdominal surgery.
  • Patients received either morphine (30 µg/kg) or clonidine (2 µg/kg) combined with bupivacaine (0.2%) via caudal injection.
  • Analgesia duration (FLACC scale), sedation, and side effects were monitored.

Main Results:

  • Clonidine group showed significantly longer analgesia (16.5 h) than morphine group (10.2 h).
  • Clonidine also resulted in prolonged sedation (7.1 h) compared to morphine (3.8 h).
  • Fewer instances of vomiting and no itching were observed in the clonidine group; no significant adverse events like hypotension or respiratory depression occurred.

Conclusions:

  • Caudal clonidine (2 µg/kg) in bupivacaine (0.2%) offers superior analgesia and sedation duration compared to morphine (30 µg/kg) in pediatric patients.
  • This combination is safe and effective for post-operative pain management in children undergoing upper abdominal surgery.
Abstract

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