Journal article

Comparison of lumbar epidural bupivacaine with fentanyl or clonidine for postoperative analgesia in children with cerebral palsy after single-event multilevel surgery

George A Chalkiadis, David Sommerfield, Janette Low, Francesca Orsini, Stephanie J Dowden, Michelle Tay, Sueann Penrose, Marinis Pirpiris, H Kerr Graham

Developmental Medicine & Child Neurology | WILEY | Published : 2016

Abstract

AIM: To compare diazepam use, muscle spasm, analgesia, and side effects when clonidine or fentanyl are added to epidural bupivacaine in children with cerebral palsy after multilevel orthopaedic surgery. METHOD: Fifty children were prospectively randomized to receive clonidine (n=24, mean age 10y 10mo [SD 2y 11mo]) or fentanyl (n=26, mean age 10y 11mo [SD 2y 10mo]). RESULTS: There was no difference in primary outcome measures: median diazepam use (fentanyl 0, interquartile range [IQR] 0-0; clonidine 0, IQR 0-0; p=0.46), any muscle spasm (no muscle spasms in: fentanyl, 36%; clonidine, 62%; p=0.11), painful muscle spasm (fentanyl 40%; clonidine 25%; p=0.46), or pain score ≥6 (none: fentanyl 44%..

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Grants

Funding Acknowledgements

We thank Mary Sheedy for help with preparing this manuscript, Farah Abdullah for data collection, and Rory Wolfe, Katherine Smith, and Michelle Wiest for statistical help. This research was supported by the Victorian Government's Operational Infrastructure Program, Australia. HKG is on the Surgeon's Advisory Board Orthopaediatrics. The remaining authors have stated that they had no interests that could be perceived as posing a bias or conflict.