Comparison of caudal bupivacaine and dexmedetomidine with caudal bupivacaine and intravenous dexmedetomidine for postoperative analgesia in children: A randomized controlled trial.
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引用次数: 0
Abstract
Background and aims: Caudal block is a part of multimodal analgesic regimen to alleviate pain in pediatric patients undergoing variety of surgeries. This study compares the effectiveness of caudal versus intravenous dexmedetomidine as an additive to caudal bupivacaine for prolonging analgesia in children posted for elective lower abdominal surgeries. The level of sedation and hemodynamic effects through both routes were also compared.
Material and methods: Ninety-six children (aged 1-8 years) of either gender scheduled for elective lower abdominal and pelvic surgeries were prospectively enrolled and randomized into two groups of 48 each: Group A (caudal bupivacaine + caudal dexmedetomidine) and Group B (caudal bupivacaine + intravenous dexmedetomidine). The postoperative pain was monitored using the Face, Legs, Activity, Cry, Consolability (FLACC) scale, and sedation was assessed using the Ramsay sedation scale (RSS).
Results: The degree of analgesia was comparable in both groups in the initial hours after surgery. Significantly higher FLACC scores were seen in Group B at 8 h (P- 0.016), 12 h (P < 0.001), and 16 h (P < 0.001), with 89.58% patients needing two rescue analgesic doses. RSS was higher in Gr=oup A till 12 h postsurgery.
Conclusion: Caudal dexmedetomidine with bupivacaine provides improved analgesia after 8 h of surgery in comparison to caudal bupivacaine with intravenous dexmedetomidine in children undergoing lower abdominal surgeries.
背景和目的:尾侧阻滞是多模式镇痛方案的一部分,以减轻儿童患者接受各种手术的疼痛。本研究比较了尾侧与静脉注射右美托咪定作为尾侧布比卡因的添加剂对选择性下腹手术儿童延长镇痛的效果。比较两种途径的镇静水平和血流动力学效果。材料和方法:前瞻性纳入96名(1-8岁)预定择期下腹部和骨盆手术的儿童(男女均可),随机分为两组,每组48人:A组(尾侧布比卡因+尾侧右美托咪定)和B组(尾侧布比卡因+静脉注射右美托咪定)。术后疼痛采用面部、腿部、活动、哭泣、安慰(FLACC)量表监测,镇静程度采用Ramsay镇静量表(RSS)评估。结果:两组患者术后最初几个小时的镇痛程度相当。B组患者在8 h (P- 0.016)、12 h (P < 0.001)和16 h (P < 0.001)时FLACC评分显著高于对照组,89.58%患者需要2次抢救镇痛剂量。术后12 h, A组相对过饱和度较高。结论:在接受下腹部手术的儿童中,与尾侧布比卡因联合静脉注射右美托咪定相比,尾侧布比卡因联合静脉注射右美托咪定术后8小时的镇痛效果更好。
期刊介绍:
The JOACP publishes original peer-reviewed research and clinical work in all branches of anaesthesiology, pain, critical care and perioperative medicine including the application to basic sciences. In addition, the journal publishes review articles, special articles, brief communications/reports, case reports, and reports of new equipment, letters to editor, book reviews and obituaries. It is international in scope and comprehensive in coverage.