The influence of sufentanil and/or clonidine on the duration of analgesia after a caudal block for hypospadias repair surgery in children

Abstract

The aim of this study was to evaluate whether the addition of clonidine, or sufentanil, or both, to a bupivacaine solution for a caudal block prolonged the period of analgesia after operation in children. Sixty ASA class I or II boys, aged between 8 months and 13 years, admitted for hypospadias repair were enrolled into a prospective randomised study. After induction of general anaesthesia and endotracheal intubation the children were allocated into four groups. Group I received 0.5 mL kg⁻¹ bupivacaine 0.25% caudally, in addition group II received 1 mg kg⁻¹ clonidine, group III 0.5 mg kg⁻¹ sufentanil and group IV 0.5 mg kg⁻¹ clonidine and 0.25 mg kg⁻¹ sufentanil. The concentrations of clonidine and sufentanil in group IV were halved to reduce possible side-effects with higher dosages. Analgesia and side-effects were assessed 2, 4, 6, 8 and 12 h after operation. No significant differences were found among the four groups for the pain scores at 2, 4, 6, 8 and 12 h. All groups had a similar frequency of vomiting and a comparable appetite and quality of night rest during the first 24 h following the operation. There was no signficant difference in the requirement for additional doses of analgesics. The addition of sufentanil, or clonidine, or both, to bupivacaine for caudal administration provides no additional clinical benefit over bupivacaine alone.