scholarly journals “EVALUATION OF DEXMEDETOMIDINE ON HEMODYNAMICS IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY”

2021 ◽  
pp. 1-2
Author(s):  
D.V.Rama Siva Naik ◽  
J.Sudheer Kumar
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Normal Saline ◽  
Surgical Stress ◽  
Saline Group ◽  
Normal Saline Group ◽  
Sympathetic Response ◽  
Adrenoceptor Agonist ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group D

The physiological response to surgical stress and anaesthesia is well documented. Laparoscopic surgery which involves insufflation with carbon dioxideproduces undesirable responses like hypertension, tachycardia and dysrhythmias. Introduction of Dexmedetomidine which is highly specific and selectiveα2 adrenoceptor agonist has been tried in various studies to modify the stress response to surgery and to have a pleasant anaesthetic outcome with minimal cardiovascular changes. In our present study we have taken the pharmacological advantage of Dexmedetomidine to study the various cardiovascular parameters at different periods during the laparoscopic procedure. The aim is to studythe effectiveness of Dexmedetomidineinattenuating the sympathetic response tolaryngoscopy and endotracheal intubation and in maintaining the hemodynamic stability in laparoscopic cholecystectomy. Materials & Methods: 30 ASA I and II patients of either sex, scheduled for elective Laparoscopic Cholecystectomy under General anaesthesia were randomly allocated to receive either 1mcg/kg of Dexmedetomidine in 100ml of 0.9% normal saline (Group D,n=30) or 100ml of 0.9% normal saline(Group S, n=30) 30min beforeinduction. Results: In patients who received Dexmedetomidine there was a statistically significant differencein heartrate, systolic blood pressure, diastolic blood pressure and meanarterial pressures during Laparoscopy and Intubation. Conclusion: Dexmedetomidine when given as a premedication before Laparoscopic Cholecystectomy attenuates the sympathetic response to laryngoscopy and intubation and provides stable intra operative hemodynamics.

scholarly journals “EVALUATION OF DEXMEDETOMIDINE ON HEMODYNAMICS IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 1-2
Author(s):  
D.V.Rama Siva Naik ◽  
J.Sudheer Kumar
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Normal Saline ◽  
Surgical Stress ◽  
Saline Group ◽  
Normal Saline Group ◽  
Sympathetic Response ◽  
Adrenoceptor Agonist ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group D

Background: The physiological response to surgical stress and anaesthesia is well documented. Laparoscopic surgery which involves insufflation with carbon dioxideproduces undesirable responses like hypertension, tachycardia and dysrhythmias. Introduction of Dexmedetomidine which is highly specific and selectiveα2 adrenoceptor agonist has been tried in various studies to modify the stress response to surgery and to have a pleasant anaesthetic outcome with minimal cardiovascular changes. In our present study we have taken the pharmacological advantage of Dexmedetomidine to study the various cardiovascular parameters at different periods during the laparoscopic procedure. The aim is to studythe effectiveness of Dexmedetomidineinattenuating the sympathetic response tolaryngoscopy and endotracheal intubation and in maintaining the hemodynamic stability in laparoscopic cholecystectomy. Materials & Methods: 30 ASA I and II patients of either sex, scheduled for elective Laparoscopic Cholecystectomy under General anaesthesia were randomly allocated to receive either 1mcg/kg of Dexmedetomidine in 100ml of 0.9% normal saline (Group D,n=30) or 100ml of 0.9% normal saline(Group S, n=30) 30min beforeinduction. Results: In patients who received Dexmedetomidine there was a statistically significant differencein heartrate, systolic blood pressure, diastolic blood pressure and meanarterial pressures during Laparoscopy and Intubation. Conclusion: Dexmedetomidine when given as a premedication before Laparoscopic Cholecystectomy attenuates the sympathetic response to laryngoscopy and intubation and provides stable intra operative hemodynamics.

The Effect of Prophylactic Ephedrine on Systemic Hypotension Caused by Induction of Anaesthesia with Propofol and Sufentanil in Elderly Hypertensive Patients: A Prospective Randomized, Double-blind Placebo-controlled Clinical Trial

2020 ◽  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Normal Saline ◽  
Saline Group ◽  
Normal Saline Group ◽  
Hypertensive Patients ◽  
Group A ◽  
Elderly Hypertensive ◽  
Elderly Hypertensive Patients ◽  
Group B

Objective: To study the effectiveness of prophylactic ephedrine to prevent hypotension caused by induction of anesthesia with propofol and sufentanil in elderly hypertensive patients. Methodology: 70 elderly ASA grade II-III hypertensive patients undergoing elective general anesthesia were randomized into two groups to receive either intravenous ephedrine,100 ug/kg in 5ml normal saline (Group B), or an equal volume of normal saline (Group A) before induction. Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were recorded at T0 (after entry to the operating room), T1 (1 min after induction), T2 (2 min after induction), T3 ( 3 min after induction), T4 (4 min after induction), T5 (when intubated), T6 (2 min after intubation), and T7 (at the start of the procedure), as well as the incidence of hypotension and bradycardia. Results: SBP, DBP and HR were not significantly different at T0 and were significantly different at T1 to T7 after anesthesia induction. There were statistically significant effect on hypotension and bradycardia between the two groups and group B have a lower risk of hypotension and bradycardia relative to group A. SBP and DBP decreased significantly after induction in both groups. HR decreased significantly in group A while increased in group B. Conclusion: Ephedrine pretreatment can minimize hypotension and bradycardia caused by propofol and sufentanil during the induction of general anesthesia in elderly patients with hypertension.

scholarly journals Intraperitoneal Hydrocortisone plus Bupivacaine versus Bupivacaine alone for Pain Relief after Laparoscopic Cholecystectomy

2016 ◽  
Vol 3 (2) ◽  
pp. 41 ◽  
Author(s):  
Mahesh Sharma ◽  
Kalpana Kharbuja ◽  
Nil Raj Sharma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Relief ◽  
Normal Saline ◽  
Randomized Study ◽  
Saline Group ◽  
Normal Saline Group ◽  
Analgesic Requirement ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Introduction: Laparoscopic cholecystectomy has been the gold standard in the treatment of gallstones since last decades. Beside several benefits of laparoscopic cholecystectomy compared with open surgery, postoperative pain is still a frequent melancholy.  Hence, pain management is utmost regarding patients' comfort. The main objective of the study was to compare the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy.   Methods: A randomized study was conducted from December 2015 to August 2015 that included 100 patients aged 20 to 60 years of both genders who were found to have symptomatic gallstones and were scheduled for elective laparoscopic cholecystectomy at Lumbini Medical College. Patients randomly received 100 mg hydrocortisone plus 100 mg bupivacaine in 200 ml normal saline (group A) or 100 mg bupivacaine in 200 ml normal saline (group B) into the peritoneum. Post-operative abdominal and shoulder pain were evaluated using Visual Analog Score (VAS). The patients were also followed up for postoperative analgesic requirements, and recovery variables. Data were collected, tabulated and analyzed statistically using SPSS version 19.   Results: Total number of patients in this study were 100. Age and gender among both groups were comparable. VAS scores for pain was significantly lower for group A as compared to group B at 0, 2, 4, 6, 12, and 24 hours. Time of oral intake in hrs for liquids and solids was statistically significant in Group A compared to Group B. Rescue analgesic requirement was also significantly low in Group A compared to Group B. Hospital stay in both group were comparable.   Conclusion: Combination of hydrocortisone plus bupivacaine can relieve pain after laparoscopic cholecystectomy better compared to bupivacaine alone when administered intraperitoneally.

Dexmedetomidine Pretreatment Improves Lipopolysaccharide-induced Iron Homeostasis Disorder in Aged Mice

2020 ◽  
Vol 17 (2) ◽  
pp. 164-170
Author(s):  
Fenghui Guo ◽  
Jinmeng Kang ◽  
Juntao Tan ◽  
Yong Wang ◽  
Li Jia ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Normal Saline ◽  
Iron Homeostasis ◽  
Saline Group ◽  
Normal Saline Group ◽  
Aged Mice ◽  
Test Kit ◽  
Km Mice ◽  
Group D ◽  
Hepcidin Mrna

Background: Iron homeostasis disorder and neuroinflammation are the most commonly known factors that promote the occurrence and development of cognitive impairment in people. Dexmedetomidine has an anti-inflammatory effect, and it reduces the incidence of postoperative cognitive dysfunction. Therefore, the aim of this study is to verify whether dexmedetomidine could improve lipopolysaccharide-induced iron homeostasis disorder in aged mice, and show neuroprotective effect. Methods: First part, forty 12 month old male Kunming(KM) mice were divided into group N and group D: Normal saline group (group N), Dexmedetomidine group (group D). Second part, sixty 12-month-old male KM mice were divided into the following three groups: Normal saline group (group N), Lipopolysaccharide group (group LPS) and Dexmedetomidine + Lipopolysaccharide group (group D + LPS). The mice in group D + LPS were given dexmedetomidine, and given LPS intraperitoneally 2 h later. Mice underwent an oriented navigation test and a space exploration test in the Morris Water maze (MWM) test. The expression levels of Interleukin-6 ( IL-6), L-ferritin (FTL) and Transferrin receptor-1 (TfR1) in hippocampus were detected by the Western blot analysis; the hippocampal hepcidin mRNA was detected by Real-time PCR(RT-PCR); the reactive oxygen species (ROS) in the hippocampus was measured using ROS test kit. Results: Dexmedetomidine improved the cognitive decline induced by LPS. Dexmedetomidine reduced the level of hippocampal IL-6, and it attenuated the increase in their levels caused by LPS. It had no effect on hippocampal hepcidin mRNA, FTL, TfR1 and ROS but it could attenuate the increase caused by LPS. Conclusion: Dexmedetomidine has no effect on iron metabolism pathway, but it can improve the cognitive decline and the iron disorder by reducing neuroinflammation and oxidative stress. The research indicates that dexmedetomidine plays a neuroprotective role.

scholarly journals Effect of Dexmedetomidine on Perioperative Haemodynamic Fluctuations in Untreated Stage 1 Hypertensive Patients Undergoing Laparoscopic Cholecystectomy- A Randomised Controlled Trial

2021 ◽  
Author(s):  
Anish Kumar Singh ◽  
Sanjay Johar ◽  
Sudesh Kumar ◽  
Mamta Jain ◽  
Kiranpreet Kaur ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Laparoscopic Cholecystectomy ◽  
Pulse Rate ◽  
Normal Saline ◽  
Double Blind Study ◽  
Rescue Analgesia ◽  
Extubation Time ◽  
Sedation Scores ◽  
Stage 1 ◽  
Group D

Introduction: Eighth Joint National Committee (JNC 8) has reclassified earlier prehypertension {Systolic Blood Pressure (SBP) 130-139 mm of Hg and/or Diastolic Blood Pressure (DBP) 80-89 mmHg} as stage 1 HTN. These patients may be at greater risk of perioperative haemodynamic instability, more so in case of laparoscopic surgeries and alpha-2 agonists premedication may be useful in such patients. Aim: To assess perioperative haemodynamic fluctuations in untreated stage 1 hypertension (HTN) patients and the role of Dexmedetomidine (Dexmed) in it. Materials and Methods: This prospective, randomised, double blind study was conducted at Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India from March 2019 to September 2020. Sixty-five patients with stage 1 HTN not on any anti-hypertensive drugs undergoing laparoscopic cholecystectomy were enrolled and randomly divided into group D (dexmedetomidine) and group NS (Normal Saline). Group D received Dexmed 1 μg/kg over 10 minutes before induction, followed by continuous infusion of Dexmed at 0.2 μg/ kg/h and Group NS received similar volume of normal saline. Serial recording of pulse rate, Mean Arterial Pressure (MAP) and oxygen saturation was done. Postoperative sedation scores, extubation time and time to first rescue analgesia were also assessed. For analysis, quantitative variables were expressed as mean±SD and compared using unpaired and paired t-test. Mann-Whitney test was used for quantitative data that did not follow a normal distribution. Qualitative variables were expressed as frequencies/percentages and compared using Chi-square test. A p-value <0.05 was considered statistically significant. Results: A total of 60 patients (30 in group NS, mean age 38.40±10.32 years and 30 in group D, mean age 42.5±11.72 years) were analysed in the present study. In NS group, haemodynamic variations were seen at induction, Laryngoscopy and Intubation (L&I), creation and release of Pneumoperitoneum (PNP) and extubation but actual changes were within 10-12% of baseline value, whereas in group D, pulse rate and MAP remained stable and moderately lower than baseline throughout the perioperative period. An increase in extubation time was observed in group D (15.57±3.16 vs.9.15±1.60 min). Group D also had significantly higher sedation scores postextubation. Group NS patients demanded rescue analgesia early (18.33±7.46 min vs.43.53±8.57 min) (p=0.001). Conclusion: It was concluded that the administration of i.v. Dexmed 1 μg/kg over 10 minutes followed by infusion at 0.2 μg/Kg/h results in haemodynamic stability during surgical stress, slightly delayed but smooth extubation, delayed demand of postoperative rescue analgesia and mild sedation of short duration. Dexmed induced effects help in improving the recovery profile of the patient and keeping the patient more comfortable in the postoperative period.

scholarly journals Clinical evaluation of general anaesthesia in pigeons using a combination of ketamine and diazepam

2012 ◽  
Vol 83 (1) ◽  
Author(s):  
Aidin Azizpour ◽  
Yashar Hassani
Keyword(s):  
General Anaesthesia ◽  
Normal Saline ◽  
Muscle Relaxation ◽  
Saline Group ◽  
Clinical Effects ◽  
Normal Saline Group ◽  
Rapid Induction ◽  
The Difference ◽  
Induction Of Anaesthesia ◽  
Group D

This study was undertaken to investigate the clinical effects of ketamine, diazepam and a ketamine and diazepam combination in the general anaesthesia of pigeons. Thirty-two pigeons of both sexes with body weights ranging from 280 g to 300 g were allocated randomly to four groups comprising eight birds each. Group D received a 0.5 mL mixture of diazepam (0.2 mg/kg) and normal saline, group K a 0.5 mL mixture of ketamine 5% (30 mg/kg) and normal saline, group D, group KD a 0.5 mL mixture of ketamine 5% (10 mg/kg), diazepam (0.2 mg/kg) and normal saline, whilst group C (control) received 0.5 mL of normal saline only. Each mixture was administered intramuscularly.Under standard operating room conditions, general anaesthesia was not observed in group C (normal saline alone). In group D, sedation and muscle relaxation without complete loss of consciousness was observed. Induction time of anaesthesia in group KD was significantly quicker than group K (p < 0.05). Duration of anaesthesia in group KD was significantly longer than group K (p < 0.05). Recovery took longer in group KD in comparison with group K, but the difference was not statistically significant (p > 0.05). The birds in group KD were calm and sedated, with good muscle relaxation, whilst in group K the birds were excited and showed a drop in body temperature.According to the results of this study, the combination of low dose ketamine hydrochloride (HCL) and diazepam overcame the adverse effects of ketamine alone. This combination produced a more rapid induction of anaesthesia, as well as an increase in anaesthesia duration, with good muscle relaxation and a smooth and slow recovery. Use of a combination of ketamine HCL given at 10 mg/kg and diazepam given at 0.2 mg/kg for anaesthesia in pigeons is therefore recommended.

scholarly journals A comparative study of dexmedetomidine versus clonidine in epidural anaesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery

2018 ◽  
Vol 6 (5) ◽  
pp. 1666
Author(s):  
Vinay Pathak ◽  
B. B. Kushwaha ◽  
Girish Chandra ◽  
V. K. Bhatia ◽  
Akash Gupta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Normal Saline ◽  
Lower Limb ◽  
Saline Group ◽  
Hemodynamic Parameters ◽  
Normal Saline Group ◽  
Time Intervals ◽  
Group A ◽  
Group B

Background: To compare study of dexmedetomidine versus clonidine in epidural anesthesia to assess the level of sedation in patients undergoing lower abdominal and lower limb surgery.Methods: This was a comparative study conducted on admitted ASA grade I and II patients undergoing lower abdominal and lower limb surgeries. The patients were divided into three groups of 30 patients each, according to the epidural medication they received:-Group A-received 15ml of bupivacaine (0.5%) and dexmedetomidine (1.0µg/kg body weight) in 1ml of normal saline; Group B-received 15ml of bupivacaine (0.5%) and clonidine (2.0µg/kg body weight) in 1ml of normal saline; Group C-received 15ml of bupivacaine (0.5%) with 1ml of normal saline. The heart rate, blood pressure, sensory dermatome level, Motor blocked level, pain and VAS were recorded at different time intervals. The side effects were also noted.Results: The baseline parameters were comparable among the groups. All the hemodynamic parameters and other study parameters were similar at Min. 0. All the hemodynamic parameters such as heart rate, blood pressure and SpO2 were variable at different time intervals. Motor block level   was significantly (p<0.05) lower in Group C than Group A and Group B from Min 50 to Min 90. The sedation score was observed to be nil in Group C. The post-op pain score became higher in Group C than Group A and Group B at subsequent time intervals. A 3 (10%) of the rescue agents was observed in Group C. Atropine (30%) and mephenteramine (10%) were common rescue agents in Group B. The bradycardia was observed in 30% patients of Group B and in 40% of Group A.Conclusions: On addition of dexmedetomidine as adjuvant to bupivacaine in epidural anesthesia provides better anesthesia and sedation than clonidine as adjuvant to bupivacaine or bupivacaine alone with mild hemodynamic changes which are easily manageable.

scholarly journals Effect of 2% Lignocaine Solution in Pain During Removal of Nasal Pack

2019 ◽  
Vol 15 (2) ◽  
pp. 80-83
Author(s):  
Ashish Dhakal ◽  
Bikash Lal Shrestha ◽  
Monika Pokharel
Keyword(s):  
Normal Saline ◽  
Saline Group ◽  
Nasal Packing ◽  
Distilled Water ◽  
Left Nostril ◽  
Normal Saline Group ◽  
Nasal Pack ◽  
Control Side ◽  
Group 5

Background: Nasal packing is commonly done after septal surgeries. Nonabsorbable nasal pack is used to minimize bleeding from surgery site, support the mucoperichondrial flaps, and minimize the risk of formation of septal hematomas and adhesions. However, these materials cause pain and discomfort in-situ as well as during removal. This study was done to evaluate the effect of 2% lignocaine rehydration of nasal pack on pain during pack removal. Methods: This prospective study was conducted on 60 patients who had undergone septoplasty. The patients were divided into 2 groups: Lignocaine and Normal saline group, with 30 patients each. In the Lignocaine group, 2.5 ml of 2% of lignocaine was diluted with 2.5 ml of distilled water and was injected into the nasal pack; and in Normal saline group, 5 ml of normal saline was injected into the nasal pack. Nothing was injected to the left nostril, which acted as a control, in both groups. All patients were asked severity of pain during removal of nasal packing by VAS. Results: In lignocaine group, mean pain score was 3.73 ± 1.63 on lignocaine side and 6.23 ± 1.69 on control side (U=109.5, p<0.001). In Normal saline group, it was 6.5 ± 1.7 on normal saline side and 6.23 ± 1.96 on control side (U=425.5, p=0.711). On comparing VAS between lignocaine and normal saline group, pain was significantly lower in the lignocaine group (U=112.5, p<0.001) Conclusion: Rehydrating nasal pack with 2% topical lignocaine is a useful method to reduce pain during nasal pack removal.

scholarly journals Effects of prophylactic ketamine and pethidine to control postanesthetic shivering: A comparative study

2018 ◽  
Vol 5 (12) ◽  
pp. 2898-2903 ◽  
Author(s):  
Masoum Khoshfetrat ◽  
Ali Rosom Jalali ◽  
Gholamreza Komeili ◽  
Aliakbar Keykha
Keyword(s):  
Normal Saline ◽  
Pearson Correlation ◽  
Saline Group ◽  
Normal Saline Group ◽  
Chi Square ◽  
Double Blind ◽  
Postanesthetic Shivering ◽  
Significant Difference ◽  
The Mean ◽  
One Way Anova

Background: Shivering is an undesirable complication following general anesthesia and spinal anesthesia, whose early control can reduce postoperative metabolic and respiratory complications. Therefore, this study aims to compare the effects of prophylactic injection of ketamine and pethidine on postoperative shivering. Methods: This double-blind clinical trial was performed on 105 patients with short-term orthopedic and ENT surgery. The patients were randomly divided into three groups; 20 minutes before the end of the surgery, 0.4 mg/kg of pethidine was injected to the first group, 0.5 mg/kg of ketamine was injected to the second group, and normal saline was injected to the third group. After the surgery, the tympanic membrane temperature was measured at 0, 10, 20, and 30 minutes. The shivering was also measured by a four-point grading from zero (no shivering) to four (severe shivering). Data were analyzed by one-way ANOVA, Kruskal Wallis, Chi-square and Pearson correlation. Results: The mean age of patients was 35.8+/-11.45 years in the ketamine group, 34.8+/-11.64 years in the normal saline group, and 33.11+/-10.5 years in the pethidine group. The one-way ANOVA showed no significant difference in the mean age between the three groups (P=0.645). The incidence and intensity of shivering were significantly higher in the normal saline group than in the ketamine and pethidine groups (p=0.001). However, there was no significant difference in the incidence and the intensity of shivering between the ketamine and the pethidine groups (p=0.936). Conclusion: The results showed that the 0.5 mg/kg of ketamine could control the post-anesthetic shivering.  

scholarly journals Comparison of Ketamine, Fentanyl and Clonidine as an Adjuvant During Bupivacaine Caudal Anaesthesia in Paediatric Patients

2013 ◽  
Vol 10 (3) ◽  
pp. 25-29
Author(s):  
Jeevan Singh ◽  
RS Shah ◽  
N Vaidya ◽  
PK Mahato ◽  
S Shrestha ◽  
...  
Keyword(s):  
Side Effects ◽  
Normal Saline ◽  
Saline Group ◽  
Single Shot ◽  
Normal Saline Group ◽  
Post Operative Pain ◽  
Caudal Anaesthesia ◽  
Caudal Analgesia ◽  
Lower Pain ◽  
Group B

Background Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of bupivacaine. Objectives To compare the efficacy of ketamine, fentanyl and clonidine in terms of quality and duration of analgesia they produce when added with caudal bupivacaine by single shot technique in children. Methods Eighty children, age one to ten years, undergoing sub-umbilical surgery, were prospectively randomized to one of four groups: caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine in normal saline (Group B) or caudal analgesia with 0.75 ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group BC) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with ketamine 0.5mg/kg (Group BK) or caudal analgesia with 0.75ml/kg of 0.25% bupivacaine with fentanyl 1mcg/kg (Group BF). Post-operative pain was assessed for 24 hours using the FLACC scale. Results The mean duration of analgesia was significantly longer in Group BC (629.06 ± 286.32 min) than other three groups P < 0.05. The pain score assessed using FLACC scale was compared between the four groups, and children in Group BC had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group BC. Clonidine in a dose of 1 μg/kg added to 0.25% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of bupivacaine, without any side effects in compare to fentanyl or ketamine. Conclusion We conclude that clonidine in a dose of 1 μg/kg, added to 0.25% bupivacaine for caudal analgesia and administered as a 0.75 ml/kg mixture in children, for sub-umbilical surgery, significantly prolongs the duration of post-operative analgesia when compared to 0.75 ml/kg of 0.25% bupivacaine in normal saline than 0.75 ml/kg of 0.25% bupivacaine with ketamine 0.5 mg/kg or 0.75 ml/kg of 0.25% bupivacaine with fentanyl 1 mcg/kg or 0.75 ml/kg of 0.25% bupivacaine alone, without any side effects. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 25-29 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8013

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