Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun;61(6):499-504.
doi: 10.4103/ija.IJA_712_16.

Comparison of analgesic efficacy of caudal dexmedetomidine versus caudal tramadol with ropivacaine in paediatric infraumbilical surgeries: A prospective, randomised, double-blinded clinical study

Savita Gupta  1 , Rashmi Sharma  1
Affiliations

Comparison of analgesic efficacy of caudal dexmedetomidine versus caudal tramadol with ropivacaine in paediatric infraumbilical surgeries: A prospective, randomised, double-blinded clinical study

Savita Gupta et al. Indian J Anaesth. 2017 Jun.

Abstract

Background and aims: Caudal epidural analgesia is commonly practised regional block technique in children undergoing infraumbilical surgeries but has a short duration of action after single shot local anaesthetic injection. The aim of this study was to compare ropivacaine 0.25% with dexmedetomidine and tramadol in caudal anaesthesia in paediatric infraumbilical surgeries.

Methods: In a randomised, prospective, double-blinded study, sixty children (1-8 years) belonging to American Society of Anesthesiologists' physical status I or II scheduled for infraumbilical surgeries were included. They were randomly assigned into two groups: Group ropivacaine with tramadol (RT) (n = 30) received 0.25% ropivacaine 1 mL/kg with 2 mg/kg of tramadol, and Group ropivacaine with dexmedetomidine (RD) (n = 30) received 0.25% ropivacaine 1 mL/kg with dexmedetomidine 2 μg/kg. The primary outcome variable was the duration of analgesia, and the secondary outcome variables included motor block, sedation score, time from caudal block to skin incision, emergence time and adverse effects.

Results: The mean duration of analgesia was 654.20 ± 78.38 min in Group RT, while in Group RD, it was 780.29 ± 71.21 min (P = 0.0001). The difference between the mean sedation score and mean emergence time between the two groups were statistically significant (P = 0.0001 and 0.0411, respectively). No significant difference was observed in the incidence of haemodynamic changes or side effects.

Conclusion: Caudal dexmedetomidine with ropivacaine prolongs post-operative analgesia compared to caudal tramadol with ropivacaine.

Keywords: Anaesthesia; analgesia; caudal block; dexmedetomidine; emergence agitation; ropivacaine; tramadol.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Haemodynamic parameters - trends of heart rate (bpm) and mean blood pressure (mmHg) in both groups at different time intervals. Values were not significantly different between the two groups at all time points. Data are presented as mean ± standard deviation
Figure 2
Figure 2
Face, legs, activity, cry, consolability score: Number of patients with adequate caudal analgesia (<4) in both groups at different time intervals. +Statistically significant compared with Group ropivacaine with tramadol
See this image and copyright information in PMC

References

    1. Dobereiner EF, Cox RG, Ewen A, Lardner DR. Evidence-based clinical update: Which local anesthetic drug for pediatric caudal block provides optimal efficacy with the fewest side effects? Can J Anaesth. 2010;57:1102–10. - PubMed
    1. Doctor TP, Dalwadi DB, Abraham L, Shah N, Chadha IA, Shah BJ. Comparison of ropivacaine and bupivacaine with fentanyl for caudal epidural in pediatric surgery. Anesth Essays Res. 2013;7:212–5. - PMC - PubMed
    1. Krishnadas A, Suvarna K, Hema VR, Taznim M. A comparison of ropivacaine, ropivacaine with tramadol and ropivacaine with midazolam for post-operative caudal epidural analgesia. Indian J Anaesth. 2016;60:827–32. - PMC - PubMed
    1. Yildiz TS, Ozdamar D, Bagus F, Solak M, Toker K. Levobupivacaine-tramadol combination for caudal block in children: A randomized, double-blinded, prospective study. Paediatr Anaesth. 2010;20:524–9. - PubMed
    1. Kaur M, Singh PM. Current role of dexmedetomidine in clinical anesthesia and intensive care. Anesth Essays Res. 2011;5:128–33. - PMC - PubMed