Department of Anaesthesiology and Intensive Care, National Academy of Medical Sciences, Mahabouddha, Kathmandu, Nepal, Nepal.
Department of Anaesthesiology and Critical Care, Kanti Childrens Hospital, Maharajgunj, Kathmandu, Nepal.
J Nepal Health Res Counc. 2024 Oct 3;22(2):336-341. doi: 10.33314/jnhrc.v22i02.5386.
Caudal block is a commonly used method of postoperative pain management in children. However, single shot caudal block has shorter duration of analgesia that can be extended by addition of adjuncts like opioids, clonididine, and dexmedetomidine along with local anesthetics. Recently, dexmedetomidine has been used as an adjunct for prolonging the duration of analgesia. This study aimed to find out prevalence of the caudal block and the duration of analgesia with dexmedetomidine adjunct among children undergoing lower abdominal surgeries.
A cross-sectional, observational study was conducted among the children admitted to the tertiary care children hospital of Nepal during the period of six months. Children of age 2 to 7 years, who had undergone lower abdominal surgeries under general anesthesia were enrolled in the study. We observed the prevalence of the caudal block and duration of analgesia of caudal dexmedetomidine with ropivacaine Results: Throughout the study period, 449 children were posted for lower abdominal surgeries. Out of which 226 children (50.03%) received caudal block. Among the caudal block, 51 children (22.56%)) were administered ropivacaine with dexmedetomidine, 45 children (19.91%) received ropivacaine alone, 43 children (19.02%) were given bupivacaine alone, 46 children (20.35%) received a combination of bupivacaine and fentanyl, and 41 children (18.14%) received bupivacaine and dexmedetomidine. Dexmedetomidine with ropivacaine provides 840.35±14.97 minutes of postoperative pain relief.
The prevalence of the caudal block was 50.03%, and the combination of Dexmedetomidine with ropivacaine provides longer duration of postoperative analgesia.
骶管阻滞是儿童术后疼痛管理中常用的方法。然而，单次骶管阻滞的镇痛持续时间较短，可以通过添加阿片类药物、可乐定和右美托咪定等辅助药物以及局部麻醉剂来延长。最近，右美托咪定已被用作延长镇痛持续时间的辅助药物。本研究旨在探讨在接受下腹部手术的儿童中，骶管阻滞的流行情况以及添加右美托咪定后镇痛的持续时间。
这是一项在尼泊尔三级儿童医院进行的横断面观察性研究。纳入年龄在 2 至 7 岁之间、接受全身麻醉下下腹部手术的儿童。观察骶管阻滞的流行情况和罗哌卡因联合右美托咪定的镇痛持续时间。
在整个研究期间，有 449 名儿童接受了下腹部手术。其中 226 名儿童（50.03%）接受了骶管阻滞。在骶管阻滞中，51 名儿童（22.56%）给予罗哌卡因联合右美托咪定，45 名儿童（19.91%）给予罗哌卡因单独使用，43 名儿童（19.02%）给予布比卡因单独使用，46 名儿童（20.35%）给予布比卡因和芬太尼的联合使用，41 名儿童（18.14%）给予布比卡因和右美托咪定。罗哌卡因联合右美托咪定可提供 840.35±14.97 分钟的术后镇痛。
骶管阻滞的流行率为 50.03%，右美托咪定与罗哌卡因联合使用可提供更长时间的术后镇痛。
