Effect of intravenous administration of dexmedetomjdine on the duration of caudal analgesia with ropivacaine in pediatrics

ABSTRACT

Dexmedetomidine is a highly selective alpha 2 agonist with potential utility in clinical anaesthesia for its sedative, anesthestic sparing and smypathlytic properties.Rrecent studies has reported a spinal site of action of dexmedetomidine in animals. The aim of the present study was to detect the effect of prior intravenous administration of dexmedetomidine on the duration of caudal analgesia with ropivacaine in pediatrics. This study was carried out on 34 children ASA I or II, age range between 2 and 4 scheduled for elective hypospadius repair, they were randomly allocated into two groups each 17 patients, Group I [Dexmedetomidine group] received 1 microgram /kg of dexmedetomidine in 50 ml of normal saline infused over 10 minutes just before genral anaesthesia and caudal analgesia with ropivacaine 0.375% of volume 0.75 ml l kg. Group II, 50 ml normal saline infused before general analgesia and the same caudal analgesia as in group I. Hear rate and blood pressure, post operative pain score by Toddler preschooler post operative pain score [TPPPS] and time of first administration of analgesics in both groups. There was statistically significant lower TPPPS in group I at 120, 150, 180, 210, 240, 300 minutes [3.2 +/- 0.7, 3.5 +/- 1.3, 3.6 +/- 1.2, 3.9 +/- 1.2, 4.6 +/- 0.3, 3.6 +/- 1.2] respectively when compared to group II at the same time of measurements TPPPS was [4.9 +/- 0.6, 5.1 +/- 1.4, 5.6 +/- 0.7, 5.4 +/- 1.2, 5.7 +/- 1.2, 4.9 +/- 2.3] respectively. Intravenous administration of dexmedetomidine prior to caudal analgesia with ropivacaine has an advantage of prolongation of low post operative pain sore in pediatrics