Adjuncts to Caudal Block in Pediatrics
Overview
- Phase
- Phase 1
- Intervention
- Dexamethasone
- Conditions
- Caudal Block
- Sponsor
- Cairo University
- Enrollment
- 63
- Primary Endpoint
- Time of first request of analgesia
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
One of the most commonly used regional anesthetic techniques in pediatric surgeries is the caudal epidural block. Its main disadvantage remains the short duration of action. Hence, different additives have been used. Dexmedetomidine as an additive to the local anesthetic bupivacaine in caudal epidural analgesia prolongs the duration of postoperative analgesia so is dexamethasone. The investigators aimed to study the effect of combining both additives in the duration of analgesia, decreasing side effects and decreasing anesthetic doses
Detailed Description
Sixty three children scheduled for hypospadias randomized into 3 groups. Group I (n=21) (dexamethasone 0.1mg/kg+ 0.5ml/kg bupivacaine 0.25%), group II(n=21)( dexmedetomidine 0.01ug/kg+ 0.5ml/kg bupivacaine 0.25%)and groupIII(n=21)(dexamethasone0.1mg/kg+dexmedetomidine0.01ug/kg +0.5ml/kg bupivacaine 0.25%).intraoperative and postoperative hemodynamics were recorded. In PACU, MOPS scores and sedation scores were recorded at 30min,1,2,3,6and 12hrs. Also the time of first analgesic request was recorded.
Investigators
Amany Hassan Saleh
principal investigator,MD of anesthesia and intensive care unit.
Cairo University
Eligibility Criteria
Inclusion Criteria
- •1 - ASA I-II 2- Males only 3- Children aged from 1-6 years 4- Children scheduled for hypospadias surgery
Exclusion Criteria
- •Contraindication to caudal anesthesia.
- •cardiovascular diseases.
- •drug allergy.
- •Type I diabetes.
- •Clotting disorders.
- •Mentally retarded children or those whose families did not approve inclusion in the study
Arms & Interventions
Dexamethasone group
In this group the patients received 0.5 ml/kg of bupivacaine 0.25% + (0.1 mg/kg dexamethazone) caudally.
Intervention: Dexamethasone
Dexamethasone group
In this group the patients received 0.5 ml/kg of bupivacaine 0.25% + (0.1 mg/kg dexamethazone) caudally.
Intervention: Bupivacaine
Dexmedetomidine group
In this group the Patients received 0.5 ml/kg of bupivacaine 0.25% + dexmedetomidine(1 mu/kg) caudally.
Intervention: Dexmedetomidine
Dexmedetomidine group
In this group the Patients received 0.5 ml/kg of bupivacaine 0.25% + dexmedetomidine(1 mu/kg) caudally.
Intervention: Bupivacaine
Combination group
In this group the patients received 0.5 ml/kg of bupivacaine 0.25% + dexamethasone(0.1mg/kg) and dexmedetomidine (1 mu/kg) caudally.
Intervention: Dexamethasone
Combination group
In this group the patients received 0.5 ml/kg of bupivacaine 0.25% + dexamethasone(0.1mg/kg) and dexmedetomidine (1 mu/kg) caudally.
Intervention: Dexmedetomidine
Combination group
In this group the patients received 0.5 ml/kg of bupivacaine 0.25% + dexamethasone(0.1mg/kg) and dexmedetomidine (1 mu/kg) caudally.
Intervention: Bupivacaine
Outcomes
Primary Outcomes
Time of first request of analgesia
Time Frame: 12 hours
the time from caudal block to the first time to analgesic needs
pain scores
Time Frame: 12 hours
the modified objective pain score
Secondary Outcomes
- sedation score(12 hours)
- heart rates(beat/minute)(3 hours.)
- mean arterial pressure (mmhg)(3 hours)