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Anesth Analg 2006;103:322-327
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000221047.68114.ad

PEDIATRIC ANESTHESIA

A Comparison of Epidural Bupivacaine-Fentanyl and Bupivacaine-Clonidine in Children Undergoing the Nuss Procedure

Giovanni Cucchiaro, MD, Scott N. Adzick, MD, John B. Rose, MD, Lynne Maxwell, MD, and Mehernoor Watcha, MD

From the Department of Anesthesiology and Critical Care Medicine and Department of Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Address correspondence to Giovanni Cucchiaro, MD, Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104. Address e-mail to cucchiaro{at}email.chop.edu.

The administration of epidural opioids, though effective for producing analgesia, has severe side effects in most patients. It is unknown whether clonidine can effectively replace opioids and cause fewer side effects. We compared, in this randomized trial, the incidence of vomiting and pruritus as well as the analgesic profile of three different combinations of bupivacaine, fentanyl, and clonidine administered epidurally in patients undergoing the Nuss procedure: bupivacaine + fentanyl, bupivacaine + clonidine, bupivacaine + fentanyl + clonidine. The incidence of side effects was significantly less in the bupivacaine + clonidine group (33%) compared with the bupivacaine + fentanyl (92%) and bupivacaine + fentanyl + clonidine (73%) groups (P = 0.004). Quality of postoperative analgesia was similar in the three groups. No significant complications were observed. In conclusion, clonidine is an effective and safe alternative to epidural opioids.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.