Comparative study between Nalbuphine and Dexmedetomidine as an adjuvant to Ropivacaine for Caudal Block in children undergoing infra umbilical surgeries

Background and Aims: The quality of caudal blocks can be improved by adding adjuvants to the local anaesthetic. Adjuvants prolong analgesia and decrease the adverse effects encountered with single high dose local anaesthetic. The objective of this study was to compare caudal nalbuphine and dexmedetomidine combined with ropivacaine to provide postoperative analgesia in children undergoing infra-umbilical surgeries.Material and Methods: This was a randomised, prospective double blinded study. A total of 60 children aged 1-12 years were randomly allocated into 2 groups: Group A received caudal block with 0.2% ropivacaine 1ml/kg with 0.2mg/kg nalbuphine and Group B received caudal block with 0.2% ropivacaine 1ml/kg with dexmedetomidine 2 µg/kg. Duration of analgesia, haemodynamic changes and adverse effects were compared. Percentage analysis and independent sample t-test were used. Chi square analysis was used for categorical variables. Results: Group A recorded duration of analgesia of 5.8± 0.88 hours, compared to 9.1 ±0.89 hours in group B and this was statistically significant.  All 30 patients in group B had lower pain scores at 4th, 5th and 9th hours.Conclusion: caudal ropivacaine 0.2% (1ml/kg) with dexmedetomidine 2 µg/kg resulted in prolongation of duration of analgesia and better quality of analgesia compared with ropivacaine 0.2% (1ml/kg) with nalbuphine 0.2mg/kg without any significant difference in the haemodynamic parameters.