Analgesic Efficacy and Safety of Dexmedetomidine as an Adjuvant to Caudal Levobupivacaine for Infraumbilical Surgeries in Children

Objective: Postoperative pain management is becoming an integral part of anaesthesia care. Single shot caudal block is a common technique for paediatric analgesia but with the disadvantage of short duration of action. Several adjuvants have been used to prolong the duration of caudal analgesia. So we designed this study using dexmedetomidine as an adjuvant with levobupicaine for caudal block to assess analgesic efficacy, duration of postoperative analgesia, hemodynamic stability and any adverse effects in children.
Methods: After getting approval by Institutional Ethical Committee and written informed consent from parents, this prospective, double blind trial was carried on 80 children aged between 1 to 12 years scheduled for elective subumbilical surgeries that were allocated randomly into one of two groups. Children in Group A received 0.25% levobupivacaine 1 mL kg-1 body weight with 0.5 mL normal saline and in Group B received 0.25% levobupivacaine 1 mL kg-1 body weight with dexmedetomidine 1 mL kg-1 in 0.5 mL normal saline as caudal drug mixture.
Results: The mean duration of analgesia in Group A was 324.±55.6 min and in Group B was 678±170.9 min which was statistically significant (p<0.001). The total analgesic requirement over 24 hours and the mean pain score was also lesser in group B.
Conclusion: Dexmedetomidine in doses of 1 μg kg-1 as an adjuvant to 0.25% levobupivacaine for caudal block in pediatric infraumbilical surgeries provides significant prolonged postoperative analgesia and better quality of sleep without any increase in adverse effects.