Background: Caudal epidural block is one of the safe, reliable and effective technique in paediatric patients but single shot caudal epidural block has short duration of analgesia that can be prolonged by addition of adjuvants like opioids, clonidine, neostigmine, ketamine or α2 agonists along with local anaesthetic agents. This prospective randomized study was conducted to assess the efficacy of addition of dexmedetomidine (1µg/kg) to caudal 0.25% ropivacaine (1ml/kg) for postoperative analgesia.
Material and Methods: Sixty American Society of Anaesthesiologists grade I and II paediatric patients aged 6 months to 6 years were randomly allocated into two groups with 30 patients in each group: Group R (n=30) received caudal 0.25% ropivacaine 1ml/ kg and normal saline (0.5 ml) while Group RD received caudal 0.25% ropivacaine 1ml/kg + dexmedetomidine 1μg/kg (0.5 ml).Postoperative pain (FLACC pain score), duration of analgesia, rescue analgesic requirement, postoperative sedation scores, haemodynamic changes along with complications were recorded.
Results: The duration of analgesia was significantly longer in group RD (797.00±59.20 min) compared to group R ( 363.30±31.44 min), ( P< 0.0001). The total number of doses of rescue analgesic required were lesser in group RD in comparison to group R .The patients in Group RD achieved higher sedation scores than Group R, which was highly significant,(P
Key words: Caudal epidural; Ropivacaine; Dexmedetomidine; Postoperative analgesia; Paediatric; Rescue analgesic