JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (21) Citing Articles via Google Scholar Google Scholar Articles by De Negri, P. Articles by Lonnqvist, P.-A. Search for Related Content PubMed PubMed Citation Articles by De Negri, P. Articles by Lonnqvist, P.-A.

---

PEDIATRIC ANESTHESIA

The Dose-Response Relationship for Clonidine Added to a Postoperative Continuous Epidural Infusion of Ropivacaine in Children

Pasquale De Negri, MD^*, Giorgio Ivani, MD, Ciro Visconti, MD^*, Paolo De Vivo, MD^*, and Per-Arne Lonnqvist, MD, PhD

*Department of Anesthesia and Intensive Care, IRCCS H "Casa Sollievo della Sofferenza" S. Giovanni Rotondo (FG), Italy; Department of Anesthesia and Intensive Care, Regina Margherita Children’s Hospital, Turin, Italy; and Department of Paediatric Anaesthesia and Intensive Care, Astrid Lindgrens Children’s Hospital, Karolinska Hospital, Stockholm, Sweden

Address correspondence and reprint requests to Pasquale De Negri, MD, Department of Anesthesia and Intensive Care, IRCCS H ‘Casa Sollievo della Sofferenza,‘ Viale Cappuccini, 71100 S. Giovanni Rotondo (FG), Italy. Address e-mail to pdenegri{at}libero.it

Epidurally administered clonidine enhances the quality and duration of postoperative analgesia when it is used as an adjunct to local anesthetics in children. We investigated the dose-response relationship for epidural clonidine when added to a continuous postoperative epidural infusion of ropivacaine. By use of an observer-blinded design, 55 pediatric patients (1–4 yr old) were randomly given a postoperative epidural infusion of plain ropivacaine 0.1% 0.2 mg · kg^-1 · h^-1 (Group R), ropivacaine 0.08% 0.16 mg · kg^-1 · h^-1 plus clonidine 0.04 µg · kg^-1 · h^-1 (Group RC1), ropivacaine 0.08% 0.16 mg · kg^-1 · h^-1 plus clonidine 0.08 µg · kg^-1 · h^-1 (Group RC2), or ropivacaine 0.08% 0.16 mg · kg^-1 · h^-1 plus clonidine 0.12 µg · kg^-1 · h^-1 (Group RC3). A clear dose-response relationship could be identified for a continuous infusion of epidural clonidine, with clonidine dosages in the 0.08–0.12 µg · kg^-1 · h^-1 range providing improved postoperative analgesia (reduced Children’s Hospital of Eastern Ontario pain score, increased time to first supplemental analgesic demand, and a reduced total number of doses of supplemental analgesics during the first 48 h after surgery). Analgesia was improved without any signs of increased sedation or other side effects. The adjunct use of epidural clonidine in the dosage range of 0.08–0.12 µg · kg^-1 · h^-1 appears effective and safe for use in children.

Implications: The addition of clonidine (0.08–0.12µg·kg^-1·h^-1)to a continuous epidural infusion of ropivacaine was found to improvepostoperative pain relief in children. No clinically significant signs ofsedation or other side effects wereobserved.

This article has been cited by other articles:

				G. Cucchiaro, S. N. Adzick, J. B. Rose, L. Maxwell, and M. Watcha A comparison of epidural bupivacaine-fentanyl and bupivacaine-clonidine in children undergoing the Nuss procedure. Anesth. Analg., August 1, 2006; 103(2): 322 - 7, table of contents. [Abstract] [Full Text] [PDF]

				R. Diaz, G. Gouvea, L. Auler, and R. Miecznikowski Thoracic Epidural Anesthesia in Pediatric Liver Transplantation Anesth. Analg., December 1, 2005; 101(6): 1891 - 1892. [Full Text] [PDF]

				P.-A. Lonnqvist and N. S. Morton Postoperative analgesia in infants and children Br. J. Anaesth., July 1, 2005; 95(1): 59 - 68. [Full Text] [PDF]

				H. T. G. Bergendahl, P. A. Lonnqvist, P. De Negri, G. Ivani, and S. Eksborg Increased Postoperative Arterial Blood Pressure Stability with Continuous Epidural Infusion of Clonidine in Children Anesth. Analg., October 1, 2002; 95(4): 1121 - 1122. [Full Text] [PDF]

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