Omara Amany Faheem, Elzohry Alaa Ali, Abdelrahman Ahmed Fetouh
Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Tanta, Egypt.
Department of Anaesthesia, ICU and Pain Relief, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
Anesth Pain Med. 2023 Feb 6;13(1):e130623. doi: 10.5812/aapm-130623. eCollection 2023 Feb.
Many parents continue to reject caudal block since they worry about a rare neurological consequence that may happen. A parenteral surrogate is sought because it can induce recovery with features such as local analgesia.
To compare the efficacy and safety of intravenous dexmedetomidine versus caudal and general anesthesia (GA) in children undergoing hypospadias surgery repair.
A randomized prospective study was conducted on 135 pediatric patients scheduled for hypospadias repair surgery in the hospital affiliated to Tanta University. The participants were divided into a control group (Group C) receiving GA, a caudal group receiving caudal block after GA, and a dexmedetomidine group (Group D) receiving intravenous dexmedetomidine after GA. The postoperative modified objective pain score (MOPS), the total pethidine received in the first 24 h postoperatively, and complications were recorded.
The patients receiving GA required a significantly higher pethidine dose than the other two groups without a significant difference between caudal and dexmedetomidine. The patients receiving dexmedetomidine were extubated significantly later than patients in the other two groups. Regarding the MOPS score, there was a significant difference between Group C and the other two groups 30 minutes and one hour after operation regarding movements, posture, and agitation. Moreover, a significantly larger number of patients developed tachycardia in Group C compared to the other groups.
With the caudal block, the benefits of smooth emergency can be obtained by intravenous dexmedetomidine; however, it had less analgesic efficacy in the pediatric patients undergoing hypospadias repair surgery.
许多家长仍然拒绝骶管阻滞，因为他们担心可能会发生罕见的神经学后果。人们在寻找一种肠外替代方法，因为它可以诱导具有局部镇痛等特征的恢复。
比较静脉注射右美托咪定与骶管阻滞及全身麻醉（GA）在小儿尿道下裂修复手术中的疗效和安全性。
对坦塔大学附属医院计划进行尿道下裂修复手术的135例儿科患者进行了一项随机前瞻性研究。参与者被分为接受GA的对照组（C组）、GA后接受骶管阻滞的骶管组和GA后接受静脉注射右美托咪定的右美托咪定组（D组）。记录术后改良客观疼痛评分（MOPS）、术后24小时内接受的哌替啶总量及并发症。
接受GA的患者所需的哌替啶剂量明显高于其他两组，骶管阻滞组和右美托咪定组之间无显著差异。接受右美托咪定的患者拔管时间明显晚于其他两组。关于MOPS评分，术后30分钟和1小时，C组与其他两组在活动、姿势和躁动方面存在显著差异。此外，与其他组相比，C组出现心动过速的患者数量明显更多。
采用骶管阻滞时，静脉注射右美托咪定可获得平稳苏醒的益处；然而，在接受尿道下裂修复手术的儿科患者中，其镇痛效果较差。
