Repository of Research and Investigative Information

Repository of Research and Investigative Information

Hormozgan University of Medical Sciences

Treatment of Postoperative Pain in Pediatric Operations: Comparing the Efficiency of Bupivacaine, Bupivacaine-Dexmedetomidine and Bupivacaine-Fentanyl for Caudal Block.

(2016) Treatment of Postoperative Pain in Pediatric Operations: Comparing the Efficiency of Bupivacaine, Bupivacaine-Dexmedetomidine and Bupivacaine-Fentanyl for Caudal Block. Anesthesiology and Pain Medicine.

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Abstract

Background: Caudal analgesia is a common method for postoperative pain management in pediatric patients. Additive agents suchasopioidsandα2 agonistshavebeenusedtoenhancetheanalgesiceffectsof localanestheticsforcaudalblock. Objectives: The aim of this study was to compare the additive effects of dexmedetomidine and fentanyl on bupivacaine-induced caudalanalgesiainpediatricpatientswhohadundergoneelectiveinguinalherniarepair. Methods: This randomized, double-blind clinical trial included children aged 1 - 5 years who were divided into three groups: the bupivacainegroup(GroupB)received0.25% bupivacaine(1ml/kg),thebupivacaine-dexmedetomidinegroup(GroupBD)received 0.25% bupivacaine(1mL/kg)plus2µg/kgdexmedetomidine,andthebupivacaine-fentanylgroup(GroupBF)received0.25% bupiva- caine(1mL/kg)plus2µg/kgfentanyl. Thehemodynamicvariables(heartrate,systolicbloodpressure,respiratoryrate,andperiph- eralarterialoxygensaturation)weremeasuredperioperatively. Pain,sedationandmotorblockscoresandadverseevents(nausea and vomiting, pruritis, hypotension, bradycardia, urinary retention and respiratory depression) were documented at 30 and 60 minutes, and the 1st, 2nd, 4th, 6th, 12th and 24th hours after the operation. The other recordings include the duration of surgery andanalgesicrequirement. Results: Atotalof 61patientswereanalyzed. ThelowestpainscoreswerefoundintheBDgroupatalltimepoints(P< 0.001). The sedationscoreswerehigherintheBDgroupthanintheothertwogroupsatalltimepoints(P< 0.001).Nomotorblockwasobserved aftertheoperation.Onlythreepatientsrequiredanalgesicadministration2to6hoursaftertheoperationingroupB.Nosideeffects wereobservedinanyof thegroups,andtherewasnosignificantdifferenceinthedurationof surgeryamongthethreegroups. Conclusions: The results show that the analgesic and sedative effects were better when dexmedetomidine was added to bupiva- caine than when fentanyl was added or bupivacaine alone was administered in the pediatric population studied here that under- wentelectiveinguinalherniarepair. Anesthesia,Caudal,Bupivacaine,Dexmedetomidine,Fentanyl,PostoperativePain

Item Type: Article
Keywords: Anesthesia,Caudal,Bupivacaine,Dexmedetomidine,Fentanyl,PostoperativePain
Subjects: anesthesiology
Divisions: Research Vice-Chancellor Department > Anaesthesiology, Critical Care and Pain Management Research Center
Depositing User: مركز تحقيقات بیهوشی و مراقبتهای ویژه
URI: http://eprints.hums.ac.ir/id/eprint/3010

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