Efficacy of fentanyl versus clonidine as an adjuvant to ropivacaine compared to ropivacaine for postoperative analgesia in caudal block for infraumblical pediatric surgeries: A prospective double-blinded randomized control study

Background: Postoperative pain and its management are a budding specialty in the medical field. The additions of adjuvants to local anesthetics were one of the effective methods to improve postoperative analgesia in terms of duration and profile. The study was done primarily to assess the duration of analgesia in terms of pain score and total analgesic requirement among fentanyl and clonidine. Materials and Methods: The study was a double-blinded randomized control trial among 72 pediatric subjects where the subjects were randomly allocated into: Fentanyl group: received 0.75 ml/kg ropivacaine 0.2% along with fentanyl 1 μg/kg, clonidine group received 0.75 ml/kg ropivacaine 0.2% along with clonidine 1 μg/kg and ropivacaine alone group received 0.75 ml/kg 0.2% ropivacaine alone. Pain was assessed by objective pain scale score and Ramsay Sedation Scale was used to assess postoperative sedation. The data were entered into Microsoft Excel and analyzed using SPSS 16. Results: Clonidine group showed bradycardia and hypotension intraoperatively and postoperatively as compared to the other groups (P < 0.05). Both the fentanyl and clonidine group showed increased sedation (3.13 [0.34] vs. 2.13 [0.54] and 1.96 [0.36]) longer duration of analgesia (15.50 [1.35], 11.67 [3.71] and 9.17 [1.86]) and lesser pain score compared to the placebo group (P < 0.05). Among the groups, clonidine showed a better profile. Conclusion: The study concluded that both fentanyl and clonidine as an adjuvant to ropivacaine showed longer duration of analgesia with increased sedation score and lesser pain score. Clonidine showed a better profile in terms of duration of analgesia, pain, and sedation.