A Single-shot Caudal Block with Clonidin for Hypospadia Repair in Children

Overview

Objective:
Our aim was to introduce single-shot caudal epidural block with bupivacaine and clonidin as a standard analgesic component of general anaesthesia in children undergoing hypospadia repair. We focused on analgesia after surgery and its side-effects.

Design:
Open prospective observation.

Setting:
Department of Anaesthesia and Intensive Care and Department of Plastic and Aestetic Surgery, St. Ann’s University Hospital Brno, Czech Republic.

Material and Method:
66 boys were included into the study. Bupivacaine (2 mg/kg) and clonidin (2.5 mcg/kg) with saline were injected into the caudal space in the volume of 0.5 ml/kg. The block was performed under general anaesthesia.

Results:
The mean age of patients was 54.86 ± 9.11 months, mean body weight 18.81 ± 9.11 kg. Spontaneous ventilation was sufficient, circulation was stable. The children were discharged from the operating theatre 2.6 minutes after the end of the surgery (range 0.5–7 minutes). 53 boys didn’t require any analgesia at the day of surgery, remaining 13 boys received the first dose of analgesics 10.3 hours (3.5–16 hours) after the caudal block.

Conclusion:
A single-shot caudal administration of the mixture containing bupivacaine 2 μg/kg and clonidin 2.5 ug/kg (total volume 0.5 ml/kg) provides reliable perioperative analgesia in the patients. The final assessment of epidural clonidin requires further research.

Key words:
postoperative analgesia – caudal block – clonidin – children – anaesthesia – pain