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The Efficacy of Dexmedetomidine as Adjuvant in Caudal Block for Postoperative Pain Relief in Children

Aparna Abhijit Bagle , Sneha Sheelvanth1 , Aparna Bagle2

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Indian Journal of Anesthesia and Analgesia 6(1):p 135-143, Jan-Feb 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.19

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Sneha Sheelvanth & Aparna Bagle. The Efficacy of Dexmedetomidine as Adjuvant in Caudal Block for Postoperative Pain Relief in Children. Indian J Anesth Analg. 2019;6(1):135-143.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Introduction: In paediatric patients, optimum pain relief is a big challenge. An effective therapy to block or modify the physiological responses to painful stimuli is essential. Hence, here is an attempt to study the addition of dexmedetomidine, an alpha-2 adrenergic receptor agonist to bupivacaine with regard to analgesic potency and side effects. Material and Methods: After approval from the institution's ethics committee, the study was conducted to compare the effect of the addition of dexmedetomidine to bupivacaine in a caudal block for postoperative analgesia in paediatric infra-umbilical surgeries. Written informed parental or guardian consent was obtained.30 cases in the age group of 1 to 6 years were studied. They were randomly divided into two groups, Group N and Group D. • Group N (n=30) – 0.25% Bupivacaine 1 ml/kg+ 0.5 ml normal saline • Group D (n=30) – 0.25% Bupivacaine 1 ml/kg+Dexmedetomidine 1 μg/kg, making the volume to 0.5 ml. The total volume for the caudal block was 1 ml/kg in both groups. • after giving general anaesthesia child was placed in the left lateral position and a caudal block was performed under sterile conditions. The postoperative pain relief was evaluated using FLACC score hourly for the first 6 hours, 2 hourly up to 12 hours and then 4 hourly up to 24 hours. Sedation is evaluated by Ramsay's sedation score. Results and Conclusion: The addition of dexmedetomidine in the dose of 1µg/kg to 0.25% bupivacaine for caudal blockade showed that the duration of analgesia for Group N was 5.86±1.21 hrs and Group D was 15.5±3.02 hrs, without any significant haemodynamic changes, safe for use in paediatric patients without any adverse effects.

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Cite this article

Sneha Sheelvanth & Aparna Bagle. The Efficacy of Dexmedetomidine as Adjuvant in Caudal Block for Postoperative Pain Relief in Children. Indian J Anesth Analg. 2019;6(1):135-143.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6119.19

Keywords

Caudal Block; Bupivacaine; Dexmedetomidine. 

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