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Efficacy of Dexmedetomidine as Adjuvant in Caudal Block for Postoperative Pain Relief in Children

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Introduction: In paediatric patients, optimum pain relief is a big challenge. An effective therapy to block or modify the physiological responses to painful stimulus is an essential. Hence, here is an attempt to study addition of dexmedetomidine, an alpha-2 adrenergic receptor agonist to bupivacaine with regards to analgesic potency and side effects. Material and Methods: After approval from institution ethics committee, the study was conducted to compare the effect of addition of dexmedetomidine to bupivacaine in caudal block for postoperative analgesia in paediatric infraumbilicalsurgeries. Written informed parental or guardian consent was obtained.30 cases in the age group of 1 to 6 years were studied. They were randomly divided into two groups, Group N and Group D. • Group N (n=30) – 0.25% Bupivacaine 1 ml/kg+ 0.5 ml normal saline • Group D (n=30) – 0.25% Bupivacaine 1 ml/kg+Dexmedetomidine 1 μg/kg, making the volume to 0.5 ml. Total volume for caudal block being 1 ml/kg in both groups. • after giving general anaesthesia child was placed in left lateral position and caudal block was performed under sterile conditions. The postoperative pain reliefwas evaluated using FLACC score hourly for first 6 hours, 2 hourly upto 12 hours and then 4 hourly upto 24 hours. Sedation is evaluated by Ramsay sedation score. Results and Conclusion: Addition of dexmedetomidine in the dose of 1µg/kg to 0.25% bupivacaine for caudal blockade showedduration of analgesia for Group N was 5.86±1.21 hrs and Group D was 15.5±3.02 hrs, without any significant haemodynamic changes, safe for use in paediatric patients without any adverse effects.

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Introduction: In paediatric patients, optimum pain relief is a big challenge. An effective therapy to block or modify the physiological responses to painful stimulus is an essential. Hence, here is an attempt to study addition of dexmedetomidine, an alpha-2 adrenergic receptor agonist to bupivacaine with regards to analgesic potency and side effects. Material and Methods: After approval from institution ethics committee, the study was conducted to compare the effect of addition of dexmedetomidine to bupivacaine in caudal block for postoperative analgesia in paediatric infraumbilicalsurgeries. Written informed parental or guardian consent was obtained.30 cases in the age group of 1 to 6 years were studied. They were randomly divided into two groups, Group N and Group D. • Group N (n=30) – 0.25% Bupivacaine 1 ml/kg+ 0.5 ml normal saline • Group D (n=30) – 0.25% Bupivacaine 1 ml/kg+Dexmedetomidine 1 μg/kg, making the volume to 0.5 ml. Total volume for caudal block being 1 ml/kg in both groups. • after giving general anaesthesia child was placed in left lateral position and caudal block was performed under sterile conditions. The postoperative pain reliefwas evaluated using FLACC score hourly for first 6 hours, 2 hourly upto 12 hours and then 4 hourly upto 24 hours. Sedation is evaluated by Ramsay sedation score. Results and Conclusion: Addition of dexmedetomidine in the dose of 1µg/kg to 0.25% bupivacaine for caudal blockade showedduration of analgesia for Group N was 5.86±1.21 hrs and Group D was 15.5±3.02 hrs, without any significant haemodynamic changes, safe for use in paediatric patients without any adverse effects.

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This page is a summary of: The Efficacy of Dexmedetomidine as Adjuvant in Caudal Block for Postoperative Pain Relief in Children, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6119.19.
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