Dexmedetomidine versus Magnesium as Adjuvants to Bupivacaine-Induced Caudal Block in Children: A Randomized, Double-Blinded, Placebo-Controlled, Trial

Authors

  • Hagar Hassanein Refaee Anesthesia and Critical Care, Cairo University, Cairo, Egypt
  • amel Amel Hanafy Abo Elela Anesthesia and Critical Care, Cairo University, Cairo, Egypt
  • Maha Gamil Hanna Anesthesia and Critical Care, Cairo University, Cairo, Egypt
  • Mai Ahmed Ali Anesthesia and Critical Care, Cairo University, Cairo, Egypt
  • Amira Mohamed El Khateeb Anesthesia and Critical Care, Cairo University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2019.024

Keywords:

Caudal block, Children, Magnesium, Dexmedetomidine

Abstract

Background:

Caudal block remains fundamental in pediatric anesthetic practice. It is very useful in a wide range of surgical procedures and has proved to have a remarkable safety record, But one of the major limitations of the single-injection technique is the relatively short duration of postoperative analgesia .Prolongation of caudal analgesia using single-shot technique has been achieved by the addition of various adjuvant.

objectives:

The aim of this work is to compare magnesium and dexmedetomidine as adjuvants to bupivacaine-induced caudal block in children undergoing lower limb orthopedic surgery.

Study design: Randomized double blind trial

Settings: pediatric OR  of a tertiary care center

Methods

A double-blinded, randomized controlled trial included 36 children, aged between 1 and 7 years, scheduled for lower limb orthopedic surgery. Patients received general anesthesia in addition to caudal block. Patients were divided into three groups: Dexmedetomidine group (n=12): received 0.5 mL/Kg bupivacaine + 2 mcg/Kg dexmedetomidine, Magnesium group (n=12): received 0.5 mL/Kg bupivacaine + 50 mg magnesium, and control group (n=12): received 0.5 mL/Kg bupivacaine + normal saline. Patients were compared according to: duration of analgesia, pain scores, sedation scores, mean arterial pressure, and heart rate.

Results

Both magnesium group and dexmedetomidine group showed better analgesic profile (duration of analgesia and pain scores) compared to the control group without significant difference between the two former groups. Dexmedetomidine group showed higher sedation score, lower mean arterial pressure and lower heart rate compared to other groups.

limitations: 1- It is a single center study. 2- We used single dose for each drugs. 3-  We performed as single shot caudal block; thus, we could not extrapolate our findings in continuous blocks.

Conclusions

Both magnesium (50mg) and dexmedetomidine (2 mcg/Kg) improved the analgesic profile of bupivacaine-induced caudal block in children. Dexmedetomidine administration was accompanied with higher sedation score and negative hemodynamic profile.

Keywords

Caudal block, children, Magnesium, Dexmedetomidine.

BACKGROUND: Caudal block remains fundamental in pediatric anaesthetic practice. It is very useful in a wide range of surgical procedures and has proved to have a remarkable safety record, But one of the major limitations of the single-injection technique is the relatively short duration of postoperative analgesia. Prolongation of caudal analgesia using single-shot technique has been achieved by the addition of various adjuvant.

AIM: This work aims to compare magnesium and dexmedetomidine as adjuvants to bupivacaine-induced caudal block in children undergoing lower limb orthopaedic surgery.

STUDY DESIGN: Randomized, double-blind trial.

SETTINGS: Pediatric or of a tertiary care centre.

METHODS: A double-blinded, randomised controlled trial included 36 children, aged between 1 and 7 years, scheduled for lower limb orthopaedic surgery. Patients received general anaesthesia in addition to the caudal block. Patients were divided into three groups: Dexmedetomidine group (n = 12): received 0.5 mL/Kg bupivacaine + 2 mcg/Kg dexmedetomidine, Magnesium group (n = 12): received 0.5 mL/Kg bupivacaine + 50 mg magnesium, and control group (n = 12): received 0.5 mL/Kg bupivacaine + normal saline. Patients were compared according to the duration of analgesia, pain scores, sedation scores, mean arterial pressure, and heart rate.

RESULTS: Both magnesium group and dexmedetomidine group showed better analgesic profile (duration of analgesia and pain scores) compared to the control group without significant difference between the two former groups. Dexmedetomidine group showed higher sedation score, lower mean arterial pressure and lower heart rate compared to other groups.

CONCLUSIONS: Both magnesium (50 mg) and dexmedetomidine (2 mcg/Kg) improved the analgesic profile of bupivacaine-induced caudal block in children. Dexmedetomidine administration was accompanied with higher sedation score and negative hemodynamic profile.

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Published

2019-01-12

How to Cite

1.
Refaee HH, Abo Elela amel AH, Hanna MG, Ali MA, El Khateeb AM. Dexmedetomidine versus Magnesium as Adjuvants to Bupivacaine-Induced Caudal Block in Children: A Randomized, Double-Blinded, Placebo-Controlled, Trial. Open Access Maced J Med Sci [Internet]. 2019 Jan. 12 [cited 2024 Mar. 28];7(1):73-6. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.024

Issue

Section

B - Clinical Sciences