BACKGROUND: Caudal epidural injection with local anaesthetics is a popular regional technique used in @entity1 and @entity1 . A disadvantage of caudal blockade is the relatively short duration of @entity86 . Opioids have traditionally been added to increase the duration of @entity1337 but have been associated with unacceptable side-effects. A number of nonopioid additives have been suggested to increase the duration of @entity1337 . METHODS: A systematic review was conducted to identify randomized control trials comparing the use of local anaesthetic to local anaesthetic with nonopioid additives for caudal blockade in @entity1 . The increase in duration of @entity1337 and side-effects were compared. RESULTS: The addition of @entity1338 to the local anaesthetic solution produces an increase in the duration of @entity1337 following caudal blockade in @entity1 (pooled weighted mean difference of 145 min with 95% confidence interval of 132-157 min). Side-effects include sedation and the potential for neonatal @entity1576 . @entity3652 and @entity1363 further increase the duration of @entity1337 , however, the potential for @entity2359 remains a concern. CONCLUSION: The evidence examined shows an increased duration of @entity1337 with @entity1338 , @entity3652 and @entity1363 . However, we are not convinced that the routine use of these adjuvants in the setting of elective outpatient surgery shows improved @entity1 outcome. It is unclear if the potential for @entity2359 is outweighed by clinical benefits. Further testing, including large clinical trials, is required before recommending routine use of nonopioid additives for caudal blockade in @entity1 .

Nonopioid additives to local anaesthetics for caudal blockade in XXXX : a systematic review.

@entity1 :: ('9606', 'Species') :: ['children', 'patient', 'infants'] @entity1337 :: ('MESH:D000699', 'Disease') :: ['analgesia'] @entity3652 :: ('MESH:D007649', 'Chemical') :: ['ketamine', 'Ketamine'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory depression'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative analgesia'] @entity1338 :: ('MESH:D003000', 'Chemical') :: ['clonidine'] @entity1363 :: ('MESH:D008874', 'Chemical') :: ['midazolam'] @entity2359 :: ('MESH:D020258', 'Disease') :: ['neurotoxicity']
@entity1 :: (9606,Species) :: ['children']
