Efficacy of caudal dexmedetomidine on stress response and post operative pain in paediatric cardiac surgery: A prospective, randomized, double blinded study

Abstract

BACKGROUND: The stress response during cardiac surgery may have deleterious effect during perioperative period. This study evaluates the efficacy of caudal dexmedetomidine on stress response and post operative pain in paediatric cardio thoracic surgery under general anaesthesia. AIM OF THE STUDY: To compare the stress response and post operative analgesia using bupivacaine (0.25%)with dexmedetomidine and bupivacaine (0.25%) with fentanyl after general anaesthesia in paediatric cardiac surgery. SECONDARY OBJECTIVES: 1. To assess the intra operative and post operative hemodynamic stability. 2. Post operative FACES pain score. 3. Extubation time. 4. Time taken to initiate post operative rescue analgesia. 5. To know the complications rate. METHODS: A prospective randamoized controlled study was conducted in 50 ASA PS I patients posted for ASD repair were randomly divided into two groups. Group A received caudal bupivacaine [0.25%] and dexmedetomidine 1mcg/kg with volume of 1.5ml/kg.Group B received caudal bupivacaine [0.25%] and fentanyl 1mcg/kg with volume of 1.5ml/kg. Serum cortisol and serum glucose were measured.Intra operative and post operative hemodynamics were recorded. RESULTS: Serum cortisol and serum glucose levels were lower in dexmedetomidine group when compared to fentanyl group. Intra operative and post operative analgesic requirements were decreased in dexmedetomidine group when compared to fentanyl group. FACES pain score comparatively low in dexmedetomidine group. CONCLUSION: Dexmedetomidine attenuates the stress response and provides better intra operative and post operative hemodynamics and pronged post operative analgesia and shorter time to extubation.so caudal dexmedetomidine proves to be superior than fentanyl