Dexamethasone versus Dexmedetomidine as Adjuvant to Ropivacaine 0.2% in Caudal Analgesia in Pediatric Infraumbilical Surgeries: A Prospective, Randomized, and Double-Blind Study
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 6
Abstract
Background: Caudal analgesia is a good, reliable, and safe technique commonly used for intra- and post-operative analgesia in pediatric patients undergoing infraumbilical surgeries. Various adjuvants are being used to improve the quality and duration of single-shot local anesthetic injection. We aimed to compare the analgesic efficacy of dexamethasone versus dexmedetomidine added as an adjuvant to ropivacaine 0.2% in pediatric caudal blocks. Methods: After approval from the institutional ethics committee and written informed consent of the parents, 60 children of age group 2-8 years, the American Society of Anesthesiologists Grade I and II, scheduled for elective infraumbilical surgeries were divided into two equal groups in a prospective, randomized, and double-blind study. Group A (n = 30) received ropivacaine 0.2% 1 mL/kg with 0.1 mg/kg of dexamethasone and Group B (n = 30), received ropivacaine 0.2% 1 mL/kg with 2 μg/kg of dexmedetomidine. Post-operative pain was assessed by modified objective pain scale score and face, legs, activity, cry, consolability score, and sedation by Ramsay sedation scale. Results: The mean duration of analgesia was 478.04 ± 61.22 min in Group A, whereas in Group B, it was 724.81 ± 36.30 min (P = 0.0001). Sedation scores between the two groups were comparable. Group B shows increased sedation score (III or IV) significantly in the first 2 h when compared to Group A. No significant difference was observed in the incidence of hemodynamic changes or side effects. Conclusion: We conclude that dexmedetomidine is a better adjuvant to ropivacaine in single-shot caudal anesthesia for pediatric infraumbilical surgeries with significant post-operative pain relief, resulting in a better quality of sleep and a prolonged duration of arousable sedation with unremarkable side effects when compared with dexamethasone.
Authors and Affiliations
P Krishna Prasad, Snehalatha Bhashyam, B Sowbhagya Lakshmi
Keywords
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