CLINICAL EVALUATION OF EFFICACY AND SAFETY OF DEXMEDETOMEDINE AS AN ADJUNCT TO CAUDAL ROPIVACAINE IN PEDIATRIC INFRAUMBILICAL SURGERIES
| Autor: | Surendra Raikwar, Aditya Agarwal, Tripti Vatsalya, Urmila Keshari |
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| Rok vydání: | 2014 |
| Předmět: | |
| Zdroj: | Journal of Evolution of Medical and Dental Sciences. 3:4967-4976 |
| ISSN: | 2278-4802 2278-4748 |
| Popis: | BACKGROUND: Caudal epidural is one of the most popular reliable & safe technique mainly used for intra and post-op analgesia in pediatric patients undergoing infra umbilical surgeries. To prolong the duration of analgesia various adjuvants like epinephrine, opioids, ketamine, midazolam, tramadol, clonidine, were added to local anesthetic. The aim of this study was to evaluate the clinical efficacy and safety of CAUDAL administration of plain Ropivacaine 0.2% (1miligram/kilogram body weight) with and without dexmedetomedine (2 microgram/kilogram body weight) in children undergoing infraumbilical surgeries; in terms of quality of surgical anesthesia and the duration of post-operative analgesia. METHOD: After approval from the institutional ethics committee and written informed consent of the parents, 60 children of (age 1-10 years) ASA gr. I and II undergoing elective lower abdominal and urogenital surgeries, were randomly divided into two groups of 30 each. After careful pre-anesthetic examination, children were kept fasting for an appropriate period prior to surgery. All patients received Injection Glycopyrrolate- 0.01 milligram /kilogram body weight, Injection midazolam- 0.1 milligram /kilogram body weight, Injection ketamine - 1 milligram /kilogram body weight, intravenously, just prior to caudal block. Caudal block was performed under all aseptic precautions. No surgical stimulus was allowed for the next 10 minutes i.e. the onset time for sensory block to occur, after which surgery was performed under the residual effect of ketamine and caudal block only. Patients were randomly allocated to receive Injection Ropivacaine 0.2% (1 milliliter/kilogram body weight; Group R) +1mililitre Normal saline or Injection Ropivacaine 0.2% (1millilitre/kilogram body weight) +Injection dexmedetomedine (2 microgram/kilogram body weight; Group RD) in Normal saline 1 milliliter. Hemodynamic parameters were observed before, during and after the surgical procedure. Quality of surgical anesthesia & requirement of supplemental midazolam/ketamine were also noted. Duration of Post-operative analgesia, pain scores, level of sedation and side effects if any were looked for and duly recorded. All the results were tabulated and analyzed statistically. The variables in the two groups were compared using the non-parametric tests. For all statistical analyses, the level of significance was P |
| Databáze: | OpenAIRE |
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