Save
LEVOBUPIVACAINE 0.25% AND MIDAZOLAM VERSUS LEVOBUPIVACAINE 0.25% AND CLONIDINE FOR EPIDURAL CAUDAL ANESTHESIA IN PEDIATRIC PATIENTS UNDERGOING HERNIOTOMY
Author(s): ,
Galante, D.*
Affiliations:
University Hospital Ospedali Riuniti of Foggia, University Department of Anesthesia and Intensive Care, Foggia, Italy
,
Badii, F.
Affiliations:
Hospital of Vittorio Veneto, Department of Anesthesia and Intensive Care, Vittorio Veneto, Italy
,
Melai, E.
Affiliations:
Ospedale Unico della Versilia, Department of Anesthesia and Intensive Care, Lido di Camaiore, Italy
,
Pedrotti, D.
Affiliations:
S. Chiara Hospital, Department of Anesthesia and Intensive Care, Trento, Italy
,
Lambo, M.S.
Affiliations:
Spirito Santo Hospital, Department of Anesthesia and Intensive Care, Pescara, Italy
,
Belpiede, C.
Affiliations:
G. Tatarella Hospital, Department of Anesthesia and Intensive Care, Cerignola Foggia, Italy
,
Aromatario, C.
Affiliations:
Spirito Santo Hospital, Department of Anesthesia and Intensive Care, Pescara, Italy
Cococcia, L.
Affiliations:
SS Annunziata Hospital, Department of Anesthesia and Intensive Care, Sulmona, Italy
ESRA Academy. Galante D. Sep 13, 2017; 190738
Dr. Dario Galante
Dr. Dario Galante

Access to Premium content is currently a membership benefit.


Click here to join ESRA or renew your membership.

Abstract
Discussion Forum (0)
Rate & Comment (0)
Background and Aims:

The purpose of our study was to compare efficacy, motor blockade and postoperative analgesia in pediatric patients after epidural caudal block with levobupivacaine/midazolam vs levobupivacaine/clonidine. 

Methods:

A systematic multicentric review of our recorded data was analyzed after ethics committee approval. 84 children aged 1-8 year were scheduled for herniotomy under deep sedation with a mixture of Air/O2 and sevoflurane without neuromuscular blockade and insertion of proseal laryngeal mask airway and receiving 1 ml/kg 0.25% caudal epidural levobupivacaine/50µg/kg midazolam or 1 ml/kg 0.25% levobupivacaine/1µg/kg clonidine. Caudal block was considered ineffective if any two of the following were present on application of painful stimulus at the operative site: 1) gross movements, 2) > 20% increase in heart rate, 3) > 20% increase in respiratory rate, 4) > 20% increase in blood pressurePostoperative pain was assessed using FLACC scale. Rescue analgesia was administered when pain score was > 4. Statistical data were analyzed using Chi-X2 test.

Results:

Both groups were homogeneous as demographics profile. Incidence of residual motor blockade at wake up was 32% with levobupivacaine/midazolam and 68% with levobupivacaine/clonidine (P = 0.004). At 120 minutes none of the patients in levobupivacaine/midazolam versus 15.88% in levobupivacaine/clonidine group had residual motor blockade (P = 0.248). Requirement of rescue drugs for postoperative pain control was similar in both the groups (P=0.615). (Figure 1)

Conclusions:

Either levobupivacaine/midazolam or levobupivacaine/clonidine provide similarly effective caudal epidural analgesia for herniotomy in children but less residual motor blockade was an additional advantage with levobupivacaine/midazolam ensuring a fast recovery and discharge of patients.

Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings