Efficacy of dexmedetomidine as an adjuvant to ropivacaine in pediatric caudal epidural block.
BACKGROUND
Caudal analgesia is a reliable and an easy method to provide intraoperative and postoperative analgesia for infraumbilical surgeries in pediatric population but with the disadvantage of short duration of action after single injection. Many additives were used in combination with local anesthetics in the caudal block to prolong the postoperative analgesia.


OBJECTIVE
We compared the analgesic effects and side effects of dexmedetomidine added to ropivacaine in pediatric patients undergoing lower abdominal surgeries.


METHODS
Double-blinded randomized controlled trial.


METHODS
Sixty patients (2-10 years) were evenly and randomly assigned into two groups in a double-blinded manner. After sevoflurane in oxygen anesthesia, each patient received a single caudal dose of ropivacaine 0.25% (1 ml/kg) combined with either dexmedetomidine 2 μg/kg in normal saline 0.5 ml, or corresponding volume of normal saline according to group assignment. Hemodynamic variables, end-tidal sevoflurane, and emergence time were monitored. Postoperative analgesia, requirement of additional analgesic, sedation, and side effects were assessed during the first 24 h.


RESULTS
The duration of postoperative analgesia was significantly longer (P= 0.001) and total consumption of rescue analgesic was significantly lower in Group RD compared with Group R (P< 0.05). Group RD have better quality of sleep and prolonged duration of sedation (P= 0.001). No significant difference was observed in the incidence of hemodynamic changes or side effects.


CONCLUSIONS
Addition of dexmedetomidine to caudal ropivacaine significantly prolongs analgesia in children undergoing lower abdominal surgeries without an increase in the incidence of side effects.
Department of Anesthesiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Manoj
M
Kamal
Department of Anesthesiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Sadik
S
Mohammed
Department of Anesthesiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Saroj
S
Meena
Department of Anesthesiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Geeta
G
Singariya
Department of Anesthesiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Rakesh
R
Kumar
Department of Anesthesiology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.
Dilip Singh
DS
Chauhan
Analgesia; Anesthetic techniques; Anesthetics local; caudal; paediatric; postoperative; regional; ropivacaine