Effect of dexmedetomidine added to caudal ropivacaine for infra-umbilical surgery in children

Introduction: Dexmedetomidine, a potent, highly selective a2 receptor agonist when added asan adjuvant to caudal local anaesthetics prolong analgesia in paediatric infra-umbilical surgeries. Present study is to assess the quality, duration of analgesia and safety profile of different concentrations of dexmedetomidine given caudally with ropivacaine and to see if a higher concentration has any added advantage. Materials and Method: In this prospective, randomized, controlled, double-blind study, 90 children were allocated to three groups of 30 each. GpR (control) received 1ml/kg 0.2% ropivacaine +0.5ml normal saline. GpRD1 and GpRD2 (interventional) received 1mcg/kg and 2mcg/kg dexmedetomidine respectively (volume made to 0.5ml), in addition to ropivacaine. General anaesthesia was induced with 50% oxygen in nitrous oxide and sevoflurane and maintained on spontaneous ventilation via face mask. Once asleep, caudal block was performed. Primary end point of the study was the duration of analgesia. Complications, if any, were recorded. Statistical Analysis: Data was analysed using SPSS version 22. One way ANOVA was used for comparison of numerical variables. If significant, Tukey's HSD -post-hoc analysis was employed for between group comparisons. P value of <0> Results: Duration of analgesia was prolonged in GpRD1 (854.67±199.98) and GpRD2 (983.83±115.59) compared to GpR (329.33±140.33mins) (p=0.000). Between GpRD1 and GpRD2, analgesia showed highly significant prolongation in GpRD2 (p = 0.005).There were no adverse effects. Conclusion: Both 1mcg/kg and 2mcg/kg dexmedetomidine having comparable sedation, safely and effectively prolongs the duration of analgesia. 2?g/kg dexmedetomidine with its better analgesia and favourable safety profile can be recommended as an excellent adjuvant to caudal ropivacaine for infraumbilical surgeries in children.