COMPARISION OF PLAIN BUPIVACAINE AND BUPIVACAINE WITH DEXMEDETOIDINE FOR CAUDAL BLOCK IN CHILDREN

Dr PS Aruna Latha; Dr A Christopher; Dr Surya Narayana

Volume : V, Issue : I, January - 2015

COMPARISION OF PLAIN BUPIVACAINE AND BUPIVACAINE WITH DEXMEDETOIDINE FOR CAUDAL BLOCK IN CHILDREN

Dr Ps Aruna Latha, Dr A Christopher, Dr Surya Narayana

Abstract :

Background & Objectiv Caudal epidural analgesia is one of the most commonly performed regional techniques in paediatric anaesthesia for intra and post–operative analgesia. However, the duration of analgesia is limited by the duration of action of local anaesthetics. Addition of opioids like morphine, fentanyl is associated with side effects like respiratory depression, urinary retention and pruritus. Dexmedetomidine a α2 agonist is known for its analgesic effects with lesser side effects. Hence, this study was conducted to know the efficacy and safety of addition of dexmedetomidine to bupivacaine in a single shot caudal block in children. Methods: This study was conducted among 60 children in the age group of 1 – 10 years coming for various elective infraumbilical surgical procedures. They were divided into two groups of 30 each. Group A received caudal 0.25% bupivacaine 1ml/kg and group B received caudal 0.25% bupivacaine 1ml/kg with dexmedetomidine 1 μg/kg. The various parameters studied were intraoperative hemodynamic changes, duration of post operative analgesia, post operative analgesic requirement and incidence of side–effects. Pain assessment was done at the 0, 1st, 2nd, 3rd, 4th, 8th, 12th, 16th, 20th and 24th hour after the surgery. Results: The groups were similar in age, sex and weight. The mean duration of analgesia in group B (598.17 ± 78.33 min) was significantly longer (p< 0.001) than in group A (298 ± 44.6 min). The pain score in the two groups were similar up to 2 hours after surgery but was higher in group A at the end of 3rd and 4th hour compared with group B. Incidence of adycardia, hypotension vomiting was comparable in both the groups Conclusion: This study showed that the addition of dexmedetomidine in the dose of 1μg/kg to 0.25% bupivacaine 1ml/kg prolonged the duration of analgesia with less post operative analgesic requirement after a single shot caudal block with minimal side effects in children.