The aim of this prospective randomized double-blind study was to compare the analgesic efficacy and the side effects of dexmedetomidine (1 µg.kg-1) co-administered with bupivacaine for caudal analgesia or intravenously in children undergoing infra-umbilical surgery.
Dexmedetomidine is used increasingly in pediatric anesthesia practice to prolong the duration of action of caudal block with a local anesthetic agent.But which route of administration of dexmedetomidine is the most beneficial remains unknown. The investigators performed prospective randomized double-blind study to compare the effects of caudal dexmedetomidine with intravenous dexmedetomidine on postoperative analgesia after caudal bupivacaine in children undergoing infra-umbilical surgery. 75 children (ASAⅠorⅡ,aged 1-6 yr) undergoing infra-umbilical surgery were included in this study. Anesthesia was induced with sevoflurane via a facemask, followed by placement of a laryngeal mask airway. Anesthesia was maintained with sevoflurane 2-3% in oxygen-air.Then,caudal block was applied. Patients were randomly assigned in three groups. Group B-Dcau (n = 25): Caudal bupivacaine 0.25% 1ml/kg plus dexmedetomidine 1µg/kg and 10 ml normal saline i.v.;Group B-Div (n = 25): bupivacaine 0.25% 1ml/kg and dexmedetomidine 1µg/kg(10 ml)i.v.;Group B(n = 25): bupivacaine 0.25% and 10 ml normal saline intravenous
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
75
Drug:Caudal bupivacaine 0.25% 1ml/kg Drug: Caudal dexmedetomidine 1µg/kg Intravenous: 10 ml normal saline sevoflurane Induction and maintenance of anesthesia
Drug:Caudal bupivacaine 0.25% 1ml/kg. Drug:Intravenous dexmedetomidine1 μg /kg in a total volume of 10 ml sevoflurane Induction and maintenance of anesthesia
Drug:Caudal bupivacaine 0.25% 1ml/kg Intravenous: Normal saline 10 ml sevoflurane Induction and maintenance of anesthesia
Time to first analgesic requirement
Time to first rescue medication. The time from end of surgery to the first requirement of postoperative analgesia,pain score ≥4
Time frame: 24 hours
Postoperative behaviour scores
behaviour score was recorded throughout the post-anesthesia care unit stay at 15-minute time intervals.
Time frame: 2 hours
Sevoflurane concentration
Sevoflurane concentration required to maintain Bispectral Index (BIS) monitor reading between 40 and 60
Time frame: 1 hour
Blood pressure Perioperative blood pressure readings
Perioperative blood pressure readings
Time frame: 2 hours
Heart Rate
Perioperative heart rate readings
Time frame: 2 hours
the incidence of emergence agitation
Participants will be followed for the duration of PACU stay, an expected average of 2 hours
Time frame: 2 hours
Postoperative pain scores
postoperative pain score will be assessed over 24 hours
Time frame: 24 hours
Side effects
side effects including nausea, vomiting and urinary retention and lower limb weakness
Time frame: 24 hours
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