COMPARISION OF DEXMEDETOMIDINE AND CLONIDINE AS ADJUVANTS TO 0.25% BUPIVACAINE IN PAEDIATRIC CAUDAL BLOCK FOR INFRAUMBILICALSURGERIES
Journal Title: INTERNATIONAL JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH - Year 2015, Vol 3, Issue 4
Abstract
Background: Caudal block is a common technique for paediatric analgesia but has disadvantage of short duration of action after single injection. Various adjuvants were tried with local anaesthetics to prolong duration of post-operative analgesia in caudal block. This prospective study was designed to assess and compare the efficacy of clonidine and dexmedetomidine used as adjuvants to bupivacaine for caudal analgesia in paediatric patients Materials and methods: The study included 60 pediatric patients undergoing infraumbilical surgeries who were separatedbased on American Society of Anesthesiologists (ASA) status I and II and belonged to the agebetween 6 monthsand 6 years. The caudal block was administered with bupivacaine 0.25% with dexmedetomidine 1 µg/kg (group D) and bupivacaine 0.25% with clonidine 1µg/kg (group C) after sedation with propofol. Hemodynamic parameters were monitored before, during, and after the surgical procedure. Postoperative analgesic duration, total dose of rescue analgesia, pain scores, and any side effects were observed. Results: Addition of dexmedetomidine or clonidine to caudal bupivacaine significantly promoted analgesic time. Also, there was statistically significant prolonged duration of analgesia with dexmedetomidine compared to clonidine. No significant difference was observed in incidence of hemodynamic changes or side effects. Conclusion: Addition of dexmedetomidine or clonidine to caudal bupivacaine signifcantly prolonged analgesia in children undergoing infraumblical surgeries. It was also observed that the performance ofdexmedetomidine was better as compared to clonidine without an increase in incidence of side-effects
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