Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics
| Autor: | I, Saadawy, A, Boker, M A, Elshahawy, A, Almazrooa, S, Melibary, A A, Abdellatif, W, Afifi |
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| Rok vydání: | 2008 |
| Předmět: |
Male
Pain Postoperative Infant Drug Synergism Hernia Inguinal Analgesics Non-Narcotic Bupivacaine Double-Blind Method Receptors Adrenergic alpha-2 Child Preschool Humans Hypnotics and Sedatives Prospective Studies Anesthetics Local Child Sleep Adrenergic alpha-Agonists Anesthesia Caudal Dexmedetomidine Psychomotor Agitation Adjuvants Anesthesia |
| Zdroj: | Acta anaesthesiologica Scandinavica. 53(2) |
| ISSN: | 1399-6576 |
| Popis: | 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 (P0.05). The duration of analgesia was significantly longer (P0.001) and the total consumption of rescue analgesic was significantly lower in Group BD compared with Group B (P0.01). 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 (P0.05).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. |
| Databáze: | OpenAIRE |
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