Efficacy and safety of dexmedetomidine as an adjuvant to caudal levobupivacaine in paediatric patients.

ntroduction Caudal block is effective and safe technique for in- fraumbilical surgeries. Several adjuvants have been used to prolong the duration of caudal analgesia. We have designed the study using dexmedetomidine as an adjuvant to levobupivacaine to assess haemodynamic stability, analgesic efficacy, and duration of postopera- tive analgesia, postoperative sedation and any adverse effects in children. We studied the safety and efficacy of dexmedetomidine as an adjuvant to levobupivacaine in caudal analgesia in pediatric patients posted for herniotomy, orchiopexy and circumcision. Materials and Methods This is a prospective, interventional study conducted in 60 children of aged 1-12 years. Patients were assigned randomly in two groups, Group L with 0.25% levobupivacaine and Group LD with 0.25% levobupivacaine and dexmedetomidine 1 μ/kg. Total volume was 1 ml/kg for herniotomy and or- chiopexy and 0.5 ml/kg for circumcision in both groups. Postoperative analgesia and sedation was assessed by using FLACC (Face, legs, activity, cry, consolability) score and 4 point sedation score respectively upto 24 h postoperatively. Unpaired student's t-test and Mann- Whitney U test was used for statistical analysis. Results Addition of dexmedetomidine to caudal levobupiva- caine significantly prolonged duration of analgesia up to 12.8 hours (p value <0.001). Group LD patients achieved statistically significant reduction in FLACC score and higher sedation compared with Group L. Peri- operative haemodynamic were stable among both groups and no adverse effects were reported postopera- tively. Conclusion Dexmedetomidine as an adjuvant to levobupivacaine is safe in paediatric patients and effectively reduces post- operative pain. However it may cause early postopera- tive sedation, yet without respiratory depression.