A Prospective Comparative Study of Efficacy and Safety of Dexmedetomidine as an Adjuvant to Caudal Levobupivacaine Versus Levobupivacaine Alone in Paediatric Patient
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 3
Abstract
Background: As the day care surgery becomes popular, caudal epidural block has become routine intervention in children and infants. But the major limitation with this technique is duration of analgesia after single injection, which is limited by the pharmacology of local anaesthetic agent used. To prolong the duration of caudal analgesia various adjuvants such as opioids, ketamine midazolam and α2 agonists are used with single shot technique.We have deigned this study to elucidate the efficacy and safety of dexmedetomidine as an adjuvant to caudal Levobupivacaine versus Levobupivacaine alone in paediatric patient. Material and Method: Present study is a randomized, prospective comparative study conducted at department of anaesthesia.Based on exclusion and inclusion criteria 80 patients were enrolled for this study. The patients were randomly allocated into two groups.Group L:- 0.75 ml/kg Levobupivacaine 0.25%, diluted in normal saline 0.9% Group LD: - 0.75 ml/kg Levobupivacaine 0.25% with Dexmedetomidine 1 µg/kg. Various parameters like cardiovascular parameter, duration of analgesia, FLACC score and adverse drug reaction was recorded and compared. Result: Both groups were comparable to each other with respect to age, sex, weight, duration of surgery and ASA scare, The P value was more than 0.05 which was statistically insignificant.After induction at 5 min, heart rate was 105.26 + 11.61 /min in group L and 106.52 + 15.22/min in group LD. The P value was 0.2162. After 15min of induction the heart rate was 107.27 + 14.41 in group L and 108.36 + 14.24/min in group LD. The P value was 0.2019 which is not significant. The time of analgesia was 342.8 + 12.4 mins in group L and in group LD it was 486.40 + 14.6 mins. Duration of analgesia was longer in group LD and is significant statistically. Discussion and Conclusion: From present study we can conclude that caudal administration of 1 µg /kg dexmedetomidine along with 0.75 ml/kg Levobupivacaine is resulted in prolongation of the duration of analgesia, less postoperative analgesic requirement as compared with 0.75ml/kg Levobupivacaine alone. There is no significant difference in hemodynamic parameters and increase incidence of adverse drug reaction.
Authors and Affiliations
Rama Rao Mokkarala
Keywords
Related Articles
- EP ID EP619866
- DOI 10.21088/ijaa.2349.8471.6319.19
- Views 95
- Downloads 0
A Comparative Study of Intubating Condition and Hemodynamic Responses Using Propofol or Thiopentone without Muscle Relaxants
Introduction: Muscle relaxants are frequently used to facilitate endotracheal intubation during the induction of anesthesia. However, the administration of short-acting depolarizing muscle relaxants is associated with po...
Evaluation of Pre-emptive Intramuscular Glycopyrrolate in Prevention of Spinal Anesthesia Induced Hypotension in Elective Cesarean Sections
Context: Spinal anesthesia induced hypotension in parturients undergoing Cesarean section can be detrimental to both foetus and mother. Prophylactic administration of vasopressors helps in preventing hypotension thereby...
Study of 2-Chlorprocaine 1% with Adjuvants Fentanyl and Buprinorphine in Comparison with Plain 2-Chlorprocaine1% for Subarachnoid Blocks in Perianal Surgeries
Introduction: This study aims at comparing the anaesthesia characteristics between Buprenorphine and Fentanyl when added as an adjuvant to intrathecal 2Chloprocaine 1% in an attempt to prolong the duration of spinal ana...
Clinical Evaluation of Adding Fentanyl versus Dexmedetomidine to Intrathecal Isobaric Levobupivacaine on Spinal Block Characteristics in Patients Scheduled for Lower Abdominal Surgeries
Background: Fentanyl, an opioid and dexmedetomidine, an alpha 2 agonist added to local anaesthetics in spinal anaesthesia potentiates local anaesthetics action, have analgesic properties and reduces the requirement of lo...
Postoperative Analgesia for Inguinal Hernia Repair: Comparison of Ropivacaine with Bupivacaine
Background and Objectives: Inguinal hernia surgery is one of the commonest day care procedures and have very high incidence of moderate to severe postoperative pain which remains a great challenge for the anesthesiologis...