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Ropivacaine Alone For Postopertive Analgesia in Children Undergoing Infraumbilical Surgeries

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Introduction: Caudal analgesia is reliable, safe and has become most popular and commomly performed regional blocks in pediatric infraumbilical surgeries but has a short duration of action without adjuvants. Dexmedetomidine a potent alpha 2 adernergic agonist, provides better hemodynamic stability and longer post operative analgesia than many other adjuvants. Ropivacaine a amide local anaesthetic, provides pain relief with less motor blockage with reduced central and cardiotoxic effects than bupivacaine. Hence study conducted with 2 groups ropivacaine alone (R) and ropivacine plus dexmedetomidine (RD) an adjuvant. Aims: Primary objective is to compare post operative analgesia between two groups, secondarily sedation. Methods: prospective, randomized study was carried out in 60 patients of ASA grade 1 and 2, aged between 2 and 8 yrs weighing <20 kg, scheduled in elective infraumbilical surgeries. In our study patients were divided into two groups of 30 each with the help of computer generated table of random numbers. Group R received 0.2% ropivacaine 1 ml/kg and Group RD received ropivacaine 0.2% 1 ml/kg plus dexmedetomidine 1 mcg/kg. Mean duration of caudal analgesia, mean duration of sedation and any other side effects were recorded in both the groups and compared. Result: The mean duration of caudal analgesia in group RD was 10.41 hrs while group R was 5.89 hrs and difference is statistically significant (p<0.001) and quality of sleep was better in group RD. Conclusion: Addition of dexmedetomidine to caudal blocks significantly prolongs post operative analgesia with arousable sedation without significant side effects.

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Introduction: Caudal analgesia is reliable, safe and has become most popular and commomly performed regional blocks in pediatric infraumbilical surgeries but has a short duration of action without adjuvants. Dexmedetomidine a potent alpha 2 adernergic agonist, provides better hemodynamic stability and longer post operative analgesia than many other adjuvants. Ropivacaine a amide local anaesthetic, provides pain relief with less motor blockage with reduced central and cardiotoxic effects than bupivacaine. Hence study conducted with 2 groups ropivacaine alone (R) and ropivacine plus dexmedetomidine (RD) an adjuvant. Aims: Primary objective is to compare post operative analgesia between two groups, secondarily sedation. Methods: prospective, randomized study was carried out in 60 patients of ASA grade 1 and 2, aged between 2 and 8 yrs weighing <20 kg, scheduled in elective infraumbilical surgeries. In our study patients were divided into two groups of 30 each with the help of computer generated table of random numbers. Group R received 0.2% ropivacaine 1 ml/kg and Group RD received ropivacaine 0.2% 1 ml/kg plus dexmedetomidine 1 mcg/kg. Mean duration of caudal analgesia, mean duration of sedation and any other side effects were recorded in both the groups and compared. Result: The mean duration of caudal analgesia in group RD was 10.41 hrs while group R was 5.89 hrs and difference is statistically significant (p<0.001) and quality of sleep was better in group RD. Conclusion: Addition of dexmedetomidine to caudal blocks significantly prolongs post operative analgesia with arousable sedation without significant side effects.

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This page is a summary of: Comparative Study of Efficacy of Caudal Ropivacaine plus Dexmedetomidine Vs Ropivacaine Alone For Postopertive Analgesia in Children Undergoing Infraumbilical Surgeries, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6319.33.
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