Effect of Intranasal Dexmedetomidine on Duration of Anesthesia and Postoperative Analgesia

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Effect of Intranasal Dexmedetomidine on Duration of Anesthesia and Postoperative Analgesia

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Background: Caudal epidural analgesia a commonly practiced regional anesthesia in children undergoing infraumbilical surgeries but, provides short duration of action after single shot of anesthesia. Objective: To explore the effect of intranasal dexmedetomidine on the duration of anesthesia and postoperative analgesia, in pediatric patients undergoing infraumbilical surgery, under single-shotcaudal epidural block. Methodology: Pediatric patients (n = 60) were randomly assigned to two Groups—A and B, Group A received intranasal dexmedetomidine (1 μg/kg of body weight) with caudal bupivacaine (0.25%, 1 ml/kg of body weight) and Group B received same, without dexmedetomidine. Vitals were recorded at regular time intervals. Postoperative anesthesia, analgesia, and sedation levels were measured by Modified Bromage Scale, FLACC scale, and Ramsay Sedation Scale. Statistical analysis wasdone using MedCalc version 17. P - value of < 0.05 was considered statistically significant. Results: Study groups were equivalent in terms of demographics and vitals. Duration of anesthesia in Group A and B were found to be 215.83 ± 16.19 mins and 137.17 ± 15.52 min, respectively, and significant difference was identified between the groups. The time from caudal block to first rescue analgesia was 12.47 ± 2.16 hour sin Group A and 3.55 ± 1.18 hours in Group B; significant variance existed between both the groups (p < 0.001). Mean sedation scores were significantly more in Group A, compared to Group B (p < 0.001). Conclusion: Intranasal dexmedetomidine (1 μg/kg) with bupivacaine (0.25 %) via caudal epidural, lengthens the duration of anesthesia and analgesia in pediatric patients, as compared to sole administration of bupivacaine, without side effects.

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