Title: Comparison of two Different Doses of Dexmedetomidine as an Adjuvant to Ropivacaine in Caudal Block for Infraumblical Surgery in Paediatric Patients
Authors: Praveen Kumar Gupta, Kanta Bhati, Kuldeep Saini, Kiwi Mantan, Peeru Singh
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.60
Abstract
Introduction: Caudal block is widely used in children for analgesia. Adequate intra and post operative analgesia will not only modify the stress response but also has been shown to reduce morbidity and mortality. Hence, we have conducted a study by using two doses (1µg/kg & 2µg/kg) of Dexmedetomidine with 0.2% Ropivacaine to maintain stable hemodynamics and provide better analgesia with minimal complications.
Aim: The aim was to compare efficacy and safety of two Different doses of Dexmedetomidine in respect to the duration & quality of perioperative analgesia and sedation as adjuvant to Ropivacaine 0.2% in paediatric caudal anaesthesia.
Method: We performed a Double blind, prospective study in 60 patients aged 3-8 years scheduled for infraumblical surgeries were randomly allocated into two groups. Group-I - 0.20% Ropivacaine 1ml/kg + 1µgm/kg of Dexmedetomidine, Group-II - 0.20% Ropivacaine 1ml/kg + 2µgm/kg of Dexmedetomidine. Patient’s hemodynamics, duration of analgesia and four point sedation score were compared between the groups and analyzed.
Result: Mean Onset time of sensory and motor block was found earlier in group-RD2 (6.36 min & 9.06 min) than group-RD1 (11.76 min & 15.2min) (p value < 0.05). Hemodynamics was comparable at all stages of surgery except the MBP was higher in group-RD1. Mean duration of Analgesia was prolonged in Group-RD2 (906.17min.) as compared with Group-RD1 (587.27 min)(p value < 0.05).Surgeons were more satisfied in group-RD2.
Conclusion: Caudal dexmedetomidine 2 µg/kg with ropivacaine 0.2% for paediatric infraumblical surgeries achieved significant postoperative pain relief up to 14 hours, which resulted in a better quality of sleep and a prolonged duration of arousable sedation upto 4 hours.
Keywords: Caudal Block, Ropivacaine, Dexmedetomidine, infraumblical surgeries
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