Analgesic efficacy and safety of a caudal bupivacaine-fentanyl mixture in children

Campbell, Fiona; Yentis, S. M.; Fear, D. W.; Bissonnette, Bruno

doi:10.1007/bf03008226

Cited by 51 publications

(31 citation statements)

References 11 publications

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“…19 They did not found any complications like nausea, vomiting, retention of urine and constipation, which is in contrasts to our study showing 10 % of retention in BF group and 5 % in B group. Similarly 15% of the patients in BF group and 10% of the patients in B group had nausea and vomiting which was in contrasts to their study.…”

Section: Original Articlecontrasting

confidence: 99%

Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Singh

Shah

Vaidya

et al. 2013

Kathmandu Univ. Med. J.

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Background Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of bupivacaine. Objectives To compare the efficacy of ketamine, fentanyl and clonidine in terms of quality and duration of analgesia they produce when added with caudal bupivacaine by single shot technique in children. Methods Eighty children, age one to ten years, undergoing sub-umbilical surgery, were prospectively randomized to one of four groups: caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine in normal saline (Group B) or caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group BC) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with ketamine 0.5mg/kg (Group BK) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with fentanyl 1mcg/kg (Group BF). Post-operative pain was assessed for 24 hours using the FLACC scale. Results The mean duration of analgesia was significantly longer in Group BC (629.06 ± 286.32 min) than other three groups P < 0.05. The pain score assessed using FLACC scale was compared between the four groups, and children in Group BC had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group BC. Clonidine in a dose of 1 μg/kg added to 0.25% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of bupivacaine, without any side effects in compare to fentanyl or ketamine. Conclusion We conclude that clonidine in a dose of 1 μg/kg, added to 0.25% bupivacaine for caudal analgesia and administered as a 0.75 ml/kg mixture in children, for sub-umbilical surgery, significantly prolongs the duration of post-operative analgesia when compared to 0.75 ml/kg of 0.25% bupivacaine in normal saline than 0.75 ml/kg of 0.25% bupivacaine with ketamine 0.5 mg/kg or 0.75 ml/kg of 0.25% bupivacaine with fentanyl 1 mcg/kg or 0.75 ml/kg of 0.25% bupivacaine alone, without any side effects. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 25-29 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8013

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Section: Original Articlecontrasting

confidence: 99%

Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Singh

Shah

Vaidya

et al. 2013

Kathmandu Univ. Med. J.

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“…Clonidine is devoid of opioid side effects but may produce excessive sedation, hypotension, and bradycardia in adults. 21 In the present study, addition of clonidine toropivacaine was found to be effective in providing effective intraoperative and postoperative analgesia. Respiratory depression is an expected but unwanted side effect of extradural opioid; 22 it has also been noticed in adult patients whoreceived clonidine 300 mg extradurally.…”

Section: Discussionmentioning

confidence: 51%

“…A sedative effect was observed after epidural clonidine in adults 23 and to a lesser degree in children. 17,18 Hypotension and bradycardia are expected side effect of extradural clonidine in adults 21 and depend on the dose administered, however in children the hemodynamic effects of extradural clonidine are less pronounced than in adults. 17,18,24 No patient had hypotension.…”

Section: Discussionmentioning

confidence: 99%

Caudal Ropivacaine with Clonidine as Adjuvant In InfraUmbilical Pediatric Surgeries for Intra-Operative And PostOperative Analgesia: An Observational Clinical Study

Verma¹,

Prasad²,

Kumar³

et al. 2017

IOSR JDMS

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“…(13) Study by Campbell et al compared caudal fentanyl (1µ/kg)-bupivacaine (0.25%) to that of bupivacaine alone also concluded having no added advantage of improved or prolonged postoperative analgesia of adding fentanyl at dose 1µ/kg. (14) Adding drugs to ropivacaine can prolong its analgesic efficacy.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Effect of Caudal Morphine and Fentanyl Added to Ropivacaine in Paediatric Infraumbilical Surgery

Swaro¹,

Banerjee²,

Kuanar³

et al. 2016

jemds

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Analgesic efficacy and safety of a caudal bupivacaine-fentanyl mixture in children

Cited by 51 publications

References 11 publications

Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

Caudal Ropivacaine with Clonidine as Adjuvant In InfraUmbilical Pediatric Surgeries for Intra-Operative And PostOperative Analgesia: An Observational Clinical Study

Comparative Study of Effect of Caudal Morphine and Fentanyl Added to Ropivacaine in Paediatric Infraumbilical Surgery

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