ABSTRACT
Introduction: Caudal epidural block is one of the most popular, reliable, and safe techniques in pediatric patients that can provide analgesia for a variety of supra- and infra-umblical surgical procedures. This study aimed to compare the efficacy of dexmedetomidine-bupivacaine, fentanyl-bupivacaine mixture and bupivacaine alone on duration of postoperative analgesia, sedation, emergence agitation, duration of sensory and motor block, hemodynamic stability and side effects
Methodology: After approval from ethical committee 90 pediatric patients of age 2-7 y were enrolled. The children were randomly allocated to three equal groups of 30 each using a computer generated randomization list. Caudal block was given after induction of general anesthesia for urogenital surgery. General anesthesia was maintained with sevoflurane at a concentration adjusted to maintain BIS between 40-60. Hemodynamic parameters, Pediatric Anaesthesia Emergence Delirium [PAED] score, Richmond agitation sedation scale [RASS], and Children's Hospital of Eastern Ontario Pain Scale [CHEOPS] were recorded immediate postoperatively and then regularly every hour for the next 12 hours
Results: PAED score was less in group BD than group B and BF from baseline. RASS Score was less in Group BD than Group BF from base line to 12 h except at 240 min and Group BF is less than Group B from base line to 12 h. Group BD was less than B from base line to 12 h. CHEOP score was less in Group BD than Group BF and Group B from base line to 12 h
Conclusion: Dexmedetomidine [1 micro g/kg] added to bupivacaine in caudal block increases the duration of postoperative analgesia, provides arousable sedation, and decreases emergence delirium with stable hemodynamics and minimal side effects in pediatric patients