Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics.

Abstract:

BACKGROUND:Dexmedetomidine (DEX) is a highly selective alpha(2)-adrenoceptor agonist that has been used increasingly in children. However, the effect of caudal DEX has not been evaluated before in children. This prospective randomized double-blinded study was designed to evaluate the analgesic efficacy of caudal DEX with bupivacaine in providing pain relief over a 24-h period. METHODS:Sixty children (ASA status I) aged 1-6 years undergoing unilateral inguinal hernia repair/orchidopexy were allocated randomly to two groups (n = 30 each). Group B received a caudal injection of bupivacaine 2.5 mg/ml, 1 ml/kg; Group BD received the same dose of bupivacaine mixed with DEX 1 microg/kg during sevoflurane anesthesia. Processed electroencephalogram (bispectral index score), heart rate, blood pressure, pulse oximetry and end-tidal sevoflurane were recorded every 5 min. The characteristics of emergence, objective pain score, sedation score and quality of sleep were recorded post-operatively. Duration of analgesia and requirement for additional analgesics were noted. RESULTS:The end-tidal sevoflurane concentration and the incidence of agitation were significantly lower in the BD group (P < 0.05). The duration of analgesia was significantly longer (P < 0.001) and the total consumption of rescue analgesic was significantly lower in Group BD compared with Group B (P < 0.01). There was no statistically significant difference in hemodynamics between both groups. However, group BD had better quality of sleep and a prolonged duration of sedation (P < 0.05). CONCLUSION:Caudal DEX seems to be a promising adjunct to provide excellent analgesia without side effects over a 24-h period. It has the advantage of keeping the patients calm for a prolonged time. Implications statement: Caudally administered DEX (1 microg/kg), combined with bupivacaine, was associated with an extended duration of post-operative pain relief.

authors

Saadawy I,Boker A,Elshahawy MA,Almazrooa A,Melibary S,Abdellatif AA,Afifi W

doi

10.1111/j.1399-6576.2008.01818.x

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

251-6

issue

2

eissn

0001-5172

issn

1399-6576

pii

AAS1818

journal_volume

53

pub_type

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