Caudal Versus Intravenous Dexmedetomidine for Caudal Analgesia in Children

Dexmedetomidine is used increasingly in pediatric anesthesia practice to prolong the duration of action of caudal block with a local anesthetic agent.But which route of administration of dexmedetomidine is the most beneficial remains unknown.

The investigators performed prospective randomized double-blind study to compare the effects of caudal dexmedetomidine with intravenous dexmedetomidine on postoperative analgesia after caudal bupivacaine in children undergoing infra-umbilical surgery.

75 children (ASAⅠorⅡ,aged 1-6 yr) undergoing infra-umbilical surgery were included in this study. Anesthesia was induced with sevoflurane via a facemask, followed by placement of a laryngeal mask airway. Anesthesia was maintained with sevoflurane 2-3% in oxygen-air.Then,caudal block was applied. Patients were randomly assigned in three groups. Group B-Dcau (n = 25): Caudal bupivacaine 0.25% 1ml/kg plus dexmedetomidine 1µg/kg and 10 ml normal saline i.v.;Group B-Div (n = 25): bupivacaine 0.25% 1ml/kg and dexmedetomidine 1µg/kg(10 ml)i.v.;Group B(n = 25): bupivacaine 0.25% and 10 ml normal saline intravenous

Inclusion criteria

• Patients with American Society of Anesthesiologists (ASA) - I
• Scheduled for lower abdominal and perineal surgery
• Under general anesthesia

Exclusion criteria

• Hypersensitivity to any local anesthetics
• Patient has history of allergy, intolerance, or reaction to dexmedetomidine
• Infections at puncture sites
• Bleeding diathesis
• Preexisting neurological disease
• Children with uncorrected cardiac lesions
• Children with heart block