Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics
- 19 January 2009
- journal article
- research article
- Published by Wiley in Acta Anaesthesiologica Scandinavica
- Vol. 53 (2), 251-256
- https://doi.org/10.1111/j.1399-6576.2008.01818.x
Abstract
Dexmedetomidine (DEX) is a highly selective alpha(2)-adrenoceptor agonist that has been used increasingly in children. However, the effect of caudal DEX has not been evaluated before in children. This prospective randomized double-blinded study was designed to evaluate the analgesic efficacy of caudal DEX with bupivacaine in providing pain relief over a 24-h period. Sixty children (ASA status I) aged 1-6 years undergoing unilateral inguinal hernia repair/orchidopexy were allocated randomly to two groups (n = 30 each). Group B received a caudal injection of bupivacaine 2.5 mg/ml, 1 ml/kg; Group BD received the same dose of bupivacaine mixed with DEX 1 microg/kg during sevoflurane anesthesia. Processed electroencephalogram (bispectral index score), heart rate, blood pressure, pulse oximetry and end-tidal sevoflurane were recorded every 5 min. The characteristics of emergence, objective pain score, sedation score and quality of sleep were recorded post-operatively. Duration of analgesia and requirement for additional analgesics were noted. The end-tidal sevoflurane concentration and the incidence of agitation were significantly lower in the BD group (P < 0.05). The duration of analgesia was significantly longer (P < 0.001) and the total consumption of rescue analgesic was significantly lower in Group BD compared with Group B (P < 0.01). There was no statistically significant difference in hemodynamics between both groups. However, group BD had better quality of sleep and a prolonged duration of sedation (P < 0.05). Caudal DEX seems to be a promising adjunct to provide excellent analgesia without side effects over a 24-h period. It has the advantage of keeping the patients calm for a prolonged time. Implications statement: Caudally administered DEX (1 microg/kg), combined with bupivacaine, was associated with an extended duration of post-operative pain relief.Keywords
This publication has 21 references indexed in Scilit:
- Intrathecal infusion therapy with dexmedetomidine‐supplemented morphine in cancer painActa Anaesthesiologica Scandinavica, 2006
- Dexmedetomidine for the treatment of postanesthesia shivering in childrenPediatric Anesthesia, 2006
- Use of dexmedetomidine in children after cardiac and thoracic surgery*Pediatric Critical Care Medicine, 2006
- Effect of low‐dose dexmedetomidine or clonidine on the characteristics of bupivacaine spinal blockActa Anaesthesiologica Scandinavica, 2006
- Caudal additives in children—solutions or problems?British Journal of Anaesthesia, 2003
- DexmedetomidineCurrent Opinion in Critical Care, 2001
- Preliminary UK experience of dexmedetomidine, a novel agent for postoperative sedation in the intensive care unitAnaesthesia, 1999
- Spinal administration of adrenergic agents produces analgesia in amphibiansEuropean Journal of Pharmacology, 1996
- PAIN MANAGEMENT IN PAEDIATRIC PATIENTSBritish Journal of Anaesthesia, 1990
- Caudal Anesthesia in ChildrenJournal of Urology, 1933