Intraoperative sedation during regional anaesthesia (Caudal epidural anaesthesia) in paediatric patients: Role of intravenous dexemedetomidine
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2018, Vol 5, Issue 4
Abstract
Introduction To avoid adverse effects of general anaesthesia regional anaesthesia RA techniques are increasingly being practiced in children for different surgeries These RA techniques are often combined with moderate degree of sedation to remain child calm and immobileWith limited literature available we planned a prospective study to evaluate the effectiveness of dexemedetomidine as an intraoperative sedative agent with RA considering its short term sedation and least respiratory depression propertyMaterials and Methods Fifty children of 18 year of age ASA grade 12 undergoing below umbilical surgery under RA caudal epidural anaesthesia were selected and studied After giving Inj Ketamine 1mgkg intravenously RA was performed with Inj Bupivacaine Then inj Dexemedetomidine 1mcgkg IV was administered as bolus over 10 min followed by continuous infusion 04 mcgkghr till completion of surgery Perioperative sedation score vital parameters peripheral oxygen saturation respiratory rate and surgeon39s satisfaction were observed The Study was considered complete till stay of patient in PACU for 2hrs Recovery time and any complications were notedResults The quality of sedation and surgeon39s satisfaction were good in all children except three children who needed extra dose of sedative The only adverse effects reported were bradycardia and hypotension in 3 patients which were well managed by reducing the infusion rateConclusion Dexemedetomidine offers an adequate level of sedation in most of the children without haemodynamic or respiratory side effects when used intraoperatively with RAKeywords Dexemedetomidine Ketamine Regional anaesthesia Caudal epidural anaesthesia
Authors and Affiliations
Udita Naithani, Yogendra Singhal, Seema Partani,, Lalit Kumar Raiger, Vikram Bedi
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