Background: Spinal anaesthesia is the fastest and most reliable form of regional anaesthesia. Additions of intrathecaly adjuvants are useful for prolonging the spinal anaesthesia effects. Subjects and Methods: The Patients were divided in three groups; Group C (control group) = received 15 mg (3 ml) of hyperbaric bupivacaine intrathecaly. Group D = received 15 mg (3 ml) of hyperbaric bupivacaine plus 4μg Dexmedetomidine intrathecally. Group F = received Hyperbaric Bupivacaine 15mg (3ml) plus 25μg fentanyl intrathecally. Results: For the total duration of sensory block p-value is 0.000003, which is less than 0.05 (α) and is highly significant. From the above p -value and scheffe post hoc test we conclude that the Bupivacaine + Dexmedetomidine has prolonged duration of sensory block as compared to bupivacaine alone and in combination with fentanyl. For the motor block p-value is 0.000000 and is less than 0.05 (α). It is highly significant. For the demand of Analgesic p-value is 0.0000001 and is less than 0.05 (α) i.e. there is highly significant difference between them. Conclusion: Intrathecal Dexmedetomidine used as an adjuvant to bupivacaine in spinal block seems to be a good alternative to intrathecal fentanyl as it produces early onset and prolonged duration of sensory and motor block without significant haemodynamic alteration and side effects.

Background: Context: Caudal analgesia is reliable and safe method for perioperative analgesia in paediatric patients for infraumbilical surgeries. To prolong the duration of caudal block, many additives are added with local anesthetics. Aim: To compare the effects of ropivacaine and dexmedetomidine mixture with plain ropivacaine in caudal block in paediatric infra umbilical surgeries. Subjects and Methods: Sixty patients of ASA grade 1 and 2, aged 6 month to 10 year, undergoing below umbilicus surgery, were divided into two groups of 30 each. Group R received 0.25 % ropivacaine (1 ml / kg) with 0.5 ml normal saline and group RD received 0.25% ropivacaine (1 ml / kg) with dexmedetomidine (1 µg / kg) in 0.5 ml normal saline. Results: The duration of postoperative analgesia was significantly longer and the requirement of rescue analgesia was significantly lower in group RD as compared to group R. Conclusion: Caudal Ropivacaine (0.25%) with dexmedetomidine (1µg / kg) proved more effective than plain ropivacaine (0.25%) in providing analgesia in paediatric infraumbilical surgeries.

Background: Caudal epidural block has been found to be a safe and simple technique in paediatric surgery below umbilicus. This study was done to make a clinical comparison between effectiveness of caudal epidural and general anaesthesia with total intravenous Ketamine, in terms of intra-op and post-op analgesia. Subjects and Methods: Fifty patients in age group 1-12 years undergoing surgery below umbilicus were divided into 2 groups .Each group had 25 patients belonging to ASA groups 1 and 2. Group A was given general anaesthesia with total intravenous Ketamine. Group B received Caudal Epidural block under brief general anaesthesia with thiopentone. Results: Caudal block using injection 1% xylocaine was found to be a valuable technique of anaesthesia in paediatric surgery below umbilicus as it offered greater advantage of post op analgesia up to 6 hours. The recovery of consciousness was rapid on account of light general anaesthesia. Conclusion: Caudal blocks are effective in alleviating pain during intra op and post op period in sub-umbilical surgeries in paediatric patients. They offer perioperative hemodynamic stability along with the added advantage of minimal post-op side effects.