A COMPARATIVE STUDY BETWEEN DEXMEDETOMIDINE AND CLONIDINE USED AS ADJUNCTS TO BUPIVACAINE FOR POST-OPERATIVE ANALGESIA BY CAUDAL BLOCK IN PAEDIATRIC PATIENTS

Abstract

Caudal anaesthesia/analgesia is simple to perform, reliable and safe. Various adjuvants are tried with local anaesthetic to prolong duration of post-operative analgesia in caudal block in paediatric patients with variable results. This prospective study was designed to assess and compare the efficacy of clonidine and dexmedetomidine used as an adjuvants to bupivacaine for caudal analgesia in paediatric patients. A 100 patients of ASA grade I or II ,age group of 6 months to 6 years undergoing infra-umblical surgeries were included in one of the following two groups. Group D received 1 μg/kg Dexmedetomidine while group C received 1 μg/kg Clonidine both with Bupivacaine plain 0.25% 1 ml/kg. Post-operative analgesia was assessed using CRIES scale. The mean duration of post-operative analgesia in group D was 14.16 ± 1.65 hours and in group C it was 11.24 ± 2.48. The prolongation of post-operative analgesia was significantly longer in group D compared to group C and the requirement of rescue analgesic doses in the first 24 post-operative hours was less in group D compared to group C. The incidence of adverse effects were statistically insignificant between the two groups.The addition of both dexmedetomidine and clonidine with bupivacaine administered caudally significantly increase the duration of post-operative analgesia.