Background:  Caudal anesthesia is one of the most used–popular regional blocks in children. This technique is a useful adjunct during general anesthesia and for providing postoperative analgesia after infra umbilical operations. The quality and level of the caudal blockade is dependent on the dose, volume, and concentration of the injected drug. This randomized prospective study was designed to assess and compare the efficacy of clonidine and   dexmedetomidine  used as adjuvants to  ropivacaine for   caudal analgesia in childrens. To Sedation was assessed by 4 point scale, pain assessed cries scale ,time of rescue analgesia and the complications.

Methods: :    Sixty children aged between 1 to 6 years, undergoing elective infra umblical surgeries were randomized into two groups; Group RC:  Received 1ml/kg of 0.25% ropivacaine and 1μg/ kg clonidine. Group RD: Received 1ml/kg of 0.25% ropivacaine and 1 μg/ kg dexmedetomidine. Postoperative analgesia was assessed by CRIES scale.

Results: The mean duration of post–operative analgesia was 14.67±1.4 hours in group RD and 9.8 ±1.15 hours in group RC. The prolongation of duration of analgesia was significant in RD in comparison to group RC. The incidences of adverse effects were statistically insignificant between the two groups.

Conclusions: Dexmeditomedine added to ropivacaine in caudal analgesia appears to provide efficious pain relief and comfortability for longer duration than clonidine added to ropivacaine in children undergoing infraumblical surgeries without any significant side effects.