Abstract

Objectives: Caudal epidural analgesia is one of the most commonly performed regional techniques in paediatric anaesthesia for intra and post-operative analgesia.Various adjuvant like α-2 agonists, ketamine, opioids etc. have been used to prolong the caudal analgesia. With favourable results dexmedetomidine, has been popularly used. Here we intend to study two different doses, 1µg/kg which has been proved to increase analgesia duration in comparison with0.5µg/kg dexmedetomidine as an adjuvant. Methods: Sixty children (aged 6months- 6years) posted for infraumbilical surgeries were randomly assigned in two groups. Group A (30) received caudal block 1ml/kg of 0.25% bupivacaine with 1 µg/kg dexmedetomidine and Group B (30) received caudal block 1ml/kg of 0.25% bupivacaine with 0.5µg/ kg dexmedetomidine. After giving premedication with 0.8 mg / kg of oral midazolam 30 minutes prior to surgery, patients were induced with propofol 2mg/kg and infusion 100µ/kg/hr started. Caudal block was performed and appropriate dosage of drug given depending on group. Patient’s heart rate, oxygen saturation and blood pressure were recorded every 5 minutes intra-operatively and postoperatively every 15 minutes for next 2 hours and then every 30 minutes until the requirement of first rescue analgesia. Total duration of analgesia and mean pain score were noted. Results: Intra-operatively there was no statistical significant difference in the heart rate, systolic, diastolic and mean arterial blood pressure between the two groups at any time interval. The total mean duration of analgesia in group A was significantly more compared to group B. Mean pain scores in the postoperative period were comparable till 660 min but later, the mean pain scores were higher in group B in comparison to group A from 660 min to the time of rescue analgesia , which was statistically significant. Other side effects were comparable in both the groups. Conclusion: Caudal dexmedetomidine (1µg/kg) with 0.25% bupivacaine for paediatric infraumbilical surgeries achieved significant post-operative pain relief compared to caudal dexmedetomidine (0.5µg/kg) with 0.25% bupivacaine. However, 0.5µg/kg dexmedetomidine had lesser side effects in comparison to 1µg/kg dexmedetomidine.

Authors and Affiliations