A study to evaluate efficacy and safety of dexmedetomidine (1 µg/Kg) as an adjuvant to caudal ropivacaine (0.25%1 Ml/Kg) in paediatric infraumbilical surgeries

Aim: Clinical evaluation of efficacy and safety of dexmedetomidine used as an adjuvant to caudal ropivacaine in paediatric infraumbilical surgeries. Materials and Method: In randomized, prospective, double blind study, 60 paediatric patients were randomly allocated into one of the two study groups of 30 each to receive caudal injection either ropivacaine (1ml/kg) + normal saline (0.5 ml) (RN) or ropivacaine (1ml/kg) + dexmedetomidine (1 µg/kg) (RD) for post operative analgesia. Pain was assessed by face, leg, activity, cry, consolability (FLACC) pain score and arousability assessed by Ramsay’s sedation score. Results: The duration of post operative analgesia in group RD was 8 hours as compared with group RN was 4 hours. The sedation scale was assessed by Ramsay’s sedation score, Group RD showed better sedation and easily arousable as compared to group RN. The number of rescue analgesia was more in group RN (mean ±SD 1.69±0.66) as compared to group RD (mean ±SD 1.22±0.43), it was statistically significant with P < 0.001. Group RN patient significantly shows higher FLACC score compared with group RD patients. Conclusion: Caudal dexmedetomidine 1 µg/kg with 0.25% of ropivacaine 1 ml/kg for paediatric patient undergoing lower abdominal surgeries achieved postoperative pain relief upto8 hours and the required dose of rescue analgesic was less with minimal adverse effects.  Keywords: Caudal block; ropivacaine; dexmedetomidine; children.