A COMPARATIVE STUDY OF CLONIDINE VERSUS  FENTANYL AS AN ADJUVANT FOR CAUDAL BLOCK IN CHILDREN

Dr.Vaishali Chandrashekhar Shelgaonkar; Dr.Vivek Lanje

Volume : VI, Issue : VI, June - 2016

A COMPARATIVE STUDY OF CLONIDINE VERSUS FENTANYL AS AN ADJUVANT FOR CAUDAL BLOCK IN CHILDREN

Dr. Vaishali Chandrashekhar Shelgaonkar, Dr. Vivek Lanje

Abstract :

 Caudal epidural block is a versatile and simple technique; but offers relatively short duration of postoperative analgesia(4–6 hrs) even with the use of long acting local anaesthetics like Bupivacaine. To improve the duration of action and quality of analgesia various additives have been used to caudal Bupivacaine. The aim of the present study was to compare effect of addition of Fentanyl or Clonidine to Bupivacaine in terms of postoperative duration of analgesia and quality of intraoperative anaesthesia. In a prospective, double–blinded, randomized controlled trial 90 children aged 1–10 years posted for elective infra umbilical surgery were randomly allocated to receive caudal Bupivacaine 0.25% 1ml/kg alone (Group B) , or addition of Fentanyl 1µgm/kg (Group BF) or Clonidine 1µgm/kg (Group BC) caudally to Bupivacaine 0.25% 1ml/kg. In addition to routine monitoring intra operatively, patients were postoperatively observed for FLACC pain score and sedation scores. Significant pain relief was observed in Group B upto 4 hours (FLACC– 4.14±1.16), in group BF upto 6 hours (FLACC– 3.71±1.22) and Group BC upto 9 hours (FLACC– 3.86±0.78). The overall haemodynamic stability was better in Group BF as compared to Group BC and group B.Thus, to conclude addition of Clonidine or Fentanyl to Bupivacaine significantly improve duration of caudal block. Also Fentanyl helps in early initiation of caudal block.