A Comparative Study between Caudal Bupivacaine (0.25%) and Caudal Bupivacaine (0.25%) with Dexmedetomidine in Children Undergoing Elective Infra-Umbilical Surgeries

Goswami, Debarati; Hazra, Avijit; Kundu, Kanak Kanti

doi:10.4172/2155-6148.1000583

Cited by 3 publications

(8 citation statements)

References 13 publications

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“…We found that the mean RSS score was significantly lower at the end of two hours and three hours in the group receiving bupivacaine-clonidine compared to the group receiving bupivacaine-dexmedetomidine. Similar to our study, Saadawy et al [20] and Goswami et al [19] found that the mean duration of sedation was significantly prolonged amongst patients belonging to the bupivacaine-dexmedetomidine group compared to patients in the bupivacaine group. Also, Hooda et al [22], Bhatia et al [24], and Meghani et al [23] found that the median sedation score was higher in patients receiving caudal bupivacaine-clonidine compared to those receiving only bupivacaine.…”

Section: Discussionsupporting

confidence: 91%

“…Both these parameters were not statistically significant. This decrease in MAP was similar to the findings by El-Hennawy et al [15], Parameswari et al [18], Goswami et al [19], Ganeshnavar et al [16], and Raval and Kartik [17], who also reported insignificant changes in MAP among their study groups.…”

Section: Discussionsupporting

confidence: 90%

“…EL-Henawy et al [15], Ganeshnavar et al [16], and Raval and Kartik [17] also found that the group receiving bupivacaine-dexmedetomidine had a longer duration of analgesia compared to the group receiving bupivacaine-clonidine. In other studies comparing bupivacaine with bupivacaine and dexmedetomidine by Saadawy et al [20], Goyal et al [21], and Goswami et al [19], children in the bupivacaine and dexmedetomidine group had a duration of analgesia significantly longer than bupivacaine alone. Also, in studies comparing bupivacaine with bupivacaine and clonidine, Parameswari et al [18], Hooda [22], Meghani et al [23], Bhatia et al [24], and Rajan et al [25] found that children receiving bupivacaine and clonidine had a significantly longer duration of analgesia than bupivacaine alone.…”

Section: Discussionmentioning

confidence: 89%

“…The expected mean duration of analgesia for the dexmedetomidine and clonidine groups was 770.21 (91. 19) minutes and 580.02 (40.38) minutes, respectively. Hence, a sample size of 24 would detect a 240 minutes difference in the duration of analgesia between the groups (with α = 0.05, β = 0.20, and power of 80%).…”

Section: Sample Size Calculationmentioning

confidence: 95%

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Addition of Clonidine or Dexmedetomidine With Bupivacaine to Prolong Caudal Analgesia in Children Undergoing Infraumbilical Surgery

Gogoi¹,

Saikia²,

Dey³

2022

Cureus

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IntroductionClonidine, a selective α2 adrenergic receptor agonist, combined with caudally administered bupivacaine, is frequently used in children to prolong the duration of postoperative analgesia following infraumbilical surgery. On the other hand, dexmedetomidine is highly selective and has a greater affinity toward α2 adrenergic receptors, especially toward its α2a subtype, accountable for more analgesic and hypnotic effects than clonidine.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 89%

Section: Sample Size Calculationmentioning

confidence: 95%

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Addition of Clonidine or Dexmedetomidine With Bupivacaine to Prolong Caudal Analgesia in Children Undergoing Infraumbilical Surgery

Gogoi¹,

Saikia²,

Dey³

2022

Cureus

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“…1 Berbagai teknik digunakan untuk mengatasi nyeri pascaoperasi, penggunaan analgetik oral dan parenteral seperti parasetamol, nonsteroid anti-inflamatory drugs (NSAID) dan opioid berhubungan dengan risiko perdarahan saluran cerna, mencetuskan serangan asma, trombositopenia, nausea, vomitus, sedasi, depresi pernapasan, hepatotoksisitas, dan nefrotoksisitas. [2][3][4][5][6] Teknik regional khususnya blokade kaudal dapat mencegah efek samping opioid dan NSAID serta memungkinkan mencapai efek analgesia yang lebih baik dengan komplikasi lebih sedikit. 7 Blokade kaudal merupakan salah satu teknik regional yang sering dilakukan pada pediatrik.…”

Section: Pendahuluanunclassified

Perbandingan Blokade Kaudal Bupivakain 0,25% dengan Kombinasi Bupivakain 0,25% dan Klonidin 1 µg/kgBB terhadap Waktu Kebutuhan Analgesik Pascaoperasi Hipospadia

Atmoko¹,

Yadi

Oktaliansah

2018

jap

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Blokade kaudal merupakan salah satu blokade regional yang digunakan pada pediatrik. Teknik ini digunakan sebagai tata laksana nyeri pascaoperasi urogenital, rektal, inguinal, dan operasi ekstremitas bawah. Penelitian ini bertujuan mengetahui perbandingan waktu kebutuhan analgesik pascaoperasi hipospadia pada blokade kaudal bupivakain 0,25% dengan kombinasi bupivakain 0,25% dan klonidin 1 µg/kgBB. Penelitian menggunakan uji klinis acak terkontrol buta tunggal dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung bulan November 2017 sampai Januari 2018. Pasien dibagi menjadi grup bupivakain 0,25% (grup B, n=15) dan grup kombinasi bupivakain 0,25% klonidin 1 µg/kgBB (grup BK, n=15). Uji statistik menggunakan uji-t tidak berpasangan dan Uji Mann-Whitney. Hasil penelitian mengungkapkan waktu kebutuhan analgesik pertama lebih lama pada grup BK (766,46±75,34 menit) dibanding dengan grup B (344,4±59,46 menit) dengan perbedaan signifikan (p<0,05). Simpulan, kombinasi bupivakain 0,25% dan klonidin 1 µg/kgBB pada blokade kaudal menghasilkan waktu kebutuhan analgesik pertama lebih lama dibanding dengan bupivakain 0,25% pascaoperasi hipospadia.

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Comparison of analgesic efficacy of caudal dexmedetomidine versus caudal tramadol with bupivacaine 0.25% in pediatric infra-umbilical surgeries

Kapadia¹,

Kapdi²,

Prajapati³

2022

Serb J Anest Inten Therapy

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Introduction: Postoperative analgesia is very important parameter for overall management of pediatric patients. Aims: To compare the analgesic efficacy of caudal dexmedetomidine versus caudal tramadol with bupivacaine 0.25 % in paediatric Infra-umbilical surgeries. Objectives: To study hemodynamic changes. The duration of post-operative analgesia and to compare motor block and post-operative sedation in both groups, as well as the side effects associated with analgesia in both the groups. Methods: The study was carried out in 60 patients of either sex belonging to ASA Grade-I/II between age group of 1 to 8 years undergoing infra umbilical surgeries. After taking written informed consent from all the patient's care taker, pre-anaesthetic evaluation was carried out and procedure was explained to patient's care taker. Patients were randomly devided into 2 groups. Group BT: Patient received 1 ml/kg 0.25% bupivacaine with tram-adol 1 mg/kg. Group BD: Patient received 1 ml/kg 0.25% bupivacaine with dexmedetomidine 1 µg/kg. Our method of anaesthesia was G. A. with caudal block. Postoperative analgesia was assessed by FLACC score for 24 hours and If FLACC ≥ 4, Paracetamol suppository (15 mg/kg) was given as rescue analgesia. Post-operative sedation was assessed by Ramsay sedation score up to 6 hr postoperatively. Postoperatively, all the patients were monitored for any complications like Nausea, Vomiting, Shivering, Bradaycardia, Hy-potension and Respiratory depression. Results: Patients were comparable in both the groups regarding age, weight, sex distribution (P > 0.05). Mean duration of surgery in group BT was 55.3 ± 9.6 mins, in group BD was 56.7 ±12.8 mins. There was no statistically significant difference in the duration of surgery between the two groups on intergroup comparison (p > 0.05). There was no statistically significant difference in mean heart rate, mean arterial pressure and mean oxygen saturation between the groups on intergroup comparison intraoperatively and postoperatively (p > 0.05). Ramsay Sedation score was 2.0 ± 0.4 at 1 hr posto-operatively in Group BT patients. So, after 1 hr of surgery, patients of BT group remained anxious, restless and agitated. While in group BD, Sedation score was 2.0 ± 0.3 at 6 hr postoperatively. Thus all patients remained cooperative , oriented and tranquil up to 6 hr post-operatively. Group BD had significant sedation compared to Group BT for 6 hrs postoperatively (p < 0.05). We observed significant difference between the groups in terms of FLACC score. Group BT patients achieved statistically significantly higher FLACC score compared with Group BD.(P < 0.05). The mean duration of analgesia was 6.9 ± 1.2 hr in Group BT, 13.2 ± 2.8 hr in Group RD (p < 0.05). There was a statistically significant prolongation in the duration of analgesia in Group BD (p < 0.05). In present study, incidence of nausea and vomiting occurred in 5 (16.7%) of patients in Group BT and 3 (6.7%) in Group BD. None of the patients had Shivering, Brady-cardia, Hypotension, Respiratory depression, Neurological sequale in both the groups.

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A Comparative Study between Caudal Bupivacaine (0.25%) and Caudal Bupivacaine (0.25%) with Dexmedetomidine in Children Undergoing Elective Infra-Umbilical Surgeries

Cited by 3 publications

References 13 publications

Addition of Clonidine or Dexmedetomidine With Bupivacaine to Prolong Caudal Analgesia in Children Undergoing Infraumbilical Surgery

Addition of Clonidine or Dexmedetomidine With Bupivacaine to Prolong Caudal Analgesia in Children Undergoing Infraumbilical Surgery

Perbandingan Blokade Kaudal Bupivakain 0,25% dengan Kombinasi Bupivakain 0,25% dan Klonidin 1 µg/kgBB terhadap Waktu Kebutuhan Analgesik Pascaoperasi Hipospadia

Comparison of analgesic efficacy of caudal dexmedetomidine versus caudal tramadol with bupivacaine 0.25% in pediatric infra-umbilical surgeries

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