Dexamethasone versus Dexmedetomidine as Adjuvant to Ropivacaine 0.2% in Caudal Analgesia in Pediatric Infraumbilical Surgeries: A Prospective, Randomized, and Double-Blind Study
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 6
Abstract
Background: Caudal analgesia is a good, reliable, and safe technique commonly used for intra- and post-operative analgesia in pediatric patients undergoing infraumbilical surgeries. Various adjuvants are being used to improve the quality and duration of single-shot local anesthetic injection. We aimed to compare the analgesic efficacy of dexamethasone versus dexmedetomidine added as an adjuvant to ropivacaine 0.2% in pediatric caudal blocks. Methods: After approval from the institutional ethics committee and written informed consent of the parents, 60 children of age group 2-8 years, the American Society of Anesthesiologists Grade I and II, scheduled for elective infraumbilical surgeries were divided into two equal groups in a prospective, randomized, and double-blind study. Group A (n = 30) received ropivacaine 0.2% 1 mL/kg with 0.1 mg/kg of dexamethasone and Group B (n = 30), received ropivacaine 0.2% 1 mL/kg with 2 μg/kg of dexmedetomidine. Post-operative pain was assessed by modified objective pain scale score and face, legs, activity, cry, consolability score, and sedation by Ramsay sedation scale. Results: The mean duration of analgesia was 478.04 ± 61.22 min in Group A, whereas in Group B, it was 724.81 ± 36.30 min (P = 0.0001). Sedation scores between the two groups were comparable. Group B shows increased sedation score (III or IV) significantly in the first 2 h when compared to Group A. No significant difference was observed in the incidence of hemodynamic changes or side effects. Conclusion: We conclude that dexmedetomidine is a better adjuvant to ropivacaine in single-shot caudal anesthesia for pediatric infraumbilical surgeries with significant post-operative pain relief, resulting in a better quality of sleep and a prolonged duration of arousable sedation with unremarkable side effects when compared with dexamethasone.
Authors and Affiliations
P Krishna Prasad, Snehalatha Bhashyam, B Sowbhagya Lakshmi
Keywords
Related Articles
- EP ID EP470936
- DOI -
- Views 85
- Downloads 0
Outcome Analysis of Tracheobronchial Injuries at a Large Service Hospital
Background: Tracheobronchial injuries, although uncommon, are potentially fatal injuries consequent to both blunt and penetrating neck and chest trauma. Majority of the patients die at the scene before reaching definitiv...
Pathological Spectrum of Gastrointestinal Stromal Tumors - A 1.5-year Experience at Kidwai Cancer Institute
Introduction: Gastrointestinal stromal tumors (GISTs) have an incidence of 10–15 per million per year worldwide. Majority of GISTs are located in the stomach (55.6%) followed by small bowel (31.8%). Some GISTs may be fou...
Predictors of Intestinal Ischemia in Small Bowel Obstruction - A Prospective Study
Background: The purpose of this prospective study is to assess the predictors of intestinal ischemia in small bowel obstruction. Materials and Methods: This study comprises of 92 cases of acute small bowel obstruction ma...
Radiological Assessment of Alignment of Knee and Prosthesis after Primary Total Knee Arthroplasty
Background: Total knee arthroplasty (TKA) is procedure which is widely performed to give functional improvement and pain relief in advanced knee arthritis patients. Nonanatomic component placement often results in compon...
Citrobacter Emerging as a Common Uropathogen in Pediatric Population
Introduction: There is a changing scenario of the epidemiology of uropathogen in the hospital setup. Citrobacter species being the inhabitants of intestinal tract is emerging as one of the leading uropathogens in pediatr...