Comparison of efficacy and safety of different doses of dexmedetomidine combined with ropivacaine for caudal block in lumbosacral surgeries a prospective randomized controlled study

The rise in spine pathology correlates with increased mechanized work and sedentary lifestyles, leading to a higher demand for spinal surgeries. Postoperative pain from lumbosacral surgeries is often due to irritation of nociceptors and mechanoreceptors, and it can persist long after surgery due to inflammatory processes. This pain can delay mobilization, increasing the risk of complications such as pneumonia and deep vein thrombosis. Caudal analgesia offers a reliable method for managing intraoperative and postoperative pain. Preemptive analgesia can also reduce sensitization from noxious stimuli. Ropivacaine, a local anesthetic, provides effective pain relief while preserving motor function. The current trend favors multimodal pain control, incorporating adjuvants like dexmedetomidine, which enhances local anesthetic efficacy. Despite the benefits, there are limited randomized studies on preemptive caudal analgesia in lumbosacral surgeries. This study aims to compare the analgesic effects and side effects of different doses of dexmedetomidine combined with ropivacaine when given as single shot caudal  epidural block preemptively.