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Clonidine-mepivacaine mixture vs plain mepivacaine in paediatric surgery

G Ivani1, G Mattioli, M Rega

  • 1Department of Anaesthesiology, G. Gaslini Children's Hospital, Genoa, Italy.

Paediatric Anaesthesia
|January 1, 1996
PubMed

Insights

Adding clonidine to mepivacaine significantly prolonged caudal analgesia in pediatric patients undergoing surgery. This combination also increased sedation duration, offering extended pain relief for children.

Area of Science:

  • Pediatric Anesthesiology
  • Pain Management
  • Pharmacology

Background:

  • Caudal epidural anesthesia is common for pediatric subumbilical surgery.
  • Optimizing analgesia duration and sedation is crucial for pediatric surgical patients.

Purpose of the Study:

  • To evaluate the effect of adding clonidine to mepivacaine for caudal extradural anesthesia in children.
  • To compare the duration of analgesia and sedation between mepivacaine alone and mepivacaine with clonidine.

Main Methods:

  • Double-blind, randomized study involving 42 children (aged 1-10) undergoing subumbilical surgery.
  • Group 1 received mepivacaine + saline; Group 2 received mepivacaine + clonidine + saline via caudal extradural.
  • Pain assessed using the Broadman objective pain scale; sedation evaluated with a sedation score.

Main Results:

  • No significant differences in demographics, surgery duration, anesthesia onset, or vital signs between groups.
  • Mean analgesia duration was significantly longer in the clonidine group (218 min) vs. the control group (143 min) (P < 0.05).
  • Sedation duration was also significantly longer in the clonidine group (172 min vs. 89 min).

Conclusions:

  • Addition of clonidine (2 mcg/kg) to mepivacaine prolongs caudal analgesia duration in pediatric patients.
  • Clonidine contributes to extended sedation, partly due to its analgesic effect and partly as a side effect.

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