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Comparative Study of Efficacy of Caudal Ropivacaine plus Dexmedetomidine Vs Ropivacaine Alone For Postopertive Analgesia in Children Undergoing Infraumbilical Surgeries

Swarna Gowri S , Harshavardhana HS1 , Swarna Gowri S2 , Priyanka Krishnamurthy3

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Indian Journal of Anesthesia and Analgesia 6(3):p 923-928, May-June 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.33

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Harshavardhana HS, Swarna Gowri S, Priyanka Krishnamurthy. Comparative Study of Efficacy of Caudal Ropivacaine plus Dexmedetomidine Vs Ropivacaine Alone For Postopertive Analgesia in Children Undergoing Infraumbilical Surgeries. Indian J Anesth Analg. 2019;6(3):923-928.

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Abstract

Introduction: Caudal analgesia is reliable, safe and has become most popular and commomly performed regional blocks in pediatric infraumbilical surgeries but has a short duration of action without adjuvants. Dexmedetomidine a potent alpha 2 adernergic agonist, provides better hemodynamic stability and longer post operative analgesia than many other adjuvants. Ropivacaine a amide local anaesthetic, provides pain relief with less motor blockage with reduced central and cardiotoxic effects than bupivacaine. Hence study conducted with 2 groups ropivacaine alone (R) and ropivacine plus dexmedetomidine (RD) an adjuvant. Aims: Primary objective is to compare post operative analgesia between two groups, secondarily sedation. Methods: prospective, randomized study was carried out in 60 patients of ASA grade 1 and 2, aged between 2 and 8 yrs weighing <20 kg, scheduled in elective infraumbilical surgeries. In our study patients were divided into two groups of 30 each with the help of computer generated table of random numbers. Group R received 0.2% ropivacaine 1 ml/kg and Group RD received ropivacaine 0.2% 1 ml/kg plus dexmedetomidine 1 mcg/kg. Mean duration of caudal analgesia, mean duration of sedation and any other side effects were recorded in both the groups and compared. Result: The mean duration of caudal analgesia in group RD was 10.41 hrs while group R was 5.89 hrs and difference is statistically significant (p<0.001) and quality of sleep was better in group RD. Conclusion: Addition of dexmedetomidine to caudal blocks significantly prolongs post operative analgesia with arousable sedation without significant side effects.

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Harshavardhana HS, Swarna Gowri S, Priyanka Krishnamurthy. Comparative Study of Efficacy of Caudal Ropivacaine plus Dexmedetomidine Vs Ropivacaine Alone For Postopertive Analgesia in Children Undergoing Infraumbilical Surgeries. Indian J Anesth Analg. 2019;6(3):923-928.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.33

Keywords

Caudal; Paediatric; Ropivacaine; Dexmedetomidine.

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