Aims & Objectives: To assess and compare duration of analgesia, hemodynamic changes, adverse effects of caudal v/s intravenous clonidine on postoperative analgesia produced by caudal levobupivacaine.

Methods: After approval from the ethical committee a randomized, double blind, controlled type study of 90 children of ASA I/II, aged  between 2  to 8 years, posted for subumbilical surgeries under caudal block were taken and randomly allocated in three groups.

·         Group A (L)(n=30) – received levobupivacaine 0.25% (0.75 ml/kg ) and 5ml normal saline IV.

·         Group B (LC_cau) (n=30)– received levobupivacaine 0.25% (0.75 ml/kg) and 2µg/kg clonidine caudally and 5ml normal saline IV.

·         Group C (LC_iv) (n=30)– received levobupivacaine 0.25% (0.75ml/kg) caudally and 2µg/kg clonidine and normal saline making total volume of 5ml IV.

Results: There was no significant difference in the duration of surgery in all three groups (40±16.1 min in group L, 44±19.4min in group LC_cau and 45.5±19.4 min in group LC_iv). The CHIPPS scores for assessment of post operative pain were significantly higher in patients of group L as compared to group LC_cau and LC_iv.  . The mean duration of post operative analgesia was (342.8±110.6min in group L, 461.4±125.6min in group LC_iv and 671.3±82.3min in group LC_cau.) ( P<0.01)  The mean sedation scores in all the three groups were comparable (P value between groups >0.5) and no motor block was observed in all the three groups. The mean rescue analgesia was highest in group L (1.4±0.6) significantly less rescue analgesics required in the group LC_cau as compared to group LC_iv (0.1±0.3 v/s 0.9±0.3)( p=<0.05).

Conclusion: Addition of clonidine (2µg/kg) as an adjuvant to caudal levobupivacaine has long lasting post operative analgesia and less no. of rescue analgesics requirement without additional side effects as compared to intravenous clonidine with caudal levobupivacaine