Dexmedetomidine enhances the efficacy of 0.25% ropivacaine for postoperative analgesia in pediatric caudal epidurals

Abstract

Background & Objectives: Caudal epidural block is one of the safe, reliable and effective technique in pediatric patients but single shot caudal epidural block has short duration of analgesia that can be prolonged by addition of adjuvants like opioids, clonidine, neostigmine, ketamine orα₂ agonists along with local anesthetic agents. This prospective randomized study was conducted to assess the efficacy of addition of dexmedetomidine (1µg/kg) to caudal 0.25% ropivacaine (1ml/kg) for postoperative analgesia.
Methodology: Sixty American Society of Anesthesiologists grade I and II pediatric patients aged 6 months to 6 years were randomly allocated into two groups with 30 patients in each group: Group R (n = 30) received caudal 0.25% ropivacaine 1 ml/kg and normal saline (0.5 ml) while Group RD received caudal 0.25% ropivacaine 1 ml/kg + dexmedetomidine 1 μg/kg (0.5 ml). Postoperative pain (FLACC pain score), duration of analgesia, rescue analgesic requirement, postoperative sedation scores, and hemodynamic changes along with complications were recorded.