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. 2023 Feb 6;13(1):e130623.
doi: 10.5812/aapm-130623. eCollection 2023 Feb.

Comparison of Caudal Block and Dexmedetomidine Infusion in Pediatric Patients Undergoing Hypospadias Repair Surgery: A Prospective, Randomized, Double-blinded Clinical Study

Amany Faheem Omara  1 , Alaa Ali Elzohry  2 , Ahmed Fetouh Abdelrahman  1
Affiliations

Comparison of Caudal Block and Dexmedetomidine Infusion in Pediatric Patients Undergoing Hypospadias Repair Surgery: A Prospective, Randomized, Double-blinded Clinical Study

Amany Faheem Omara et al. Anesth Pain Med. .

Abstract

Background: 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.

Objectives: To compare the efficacy and safety of intravenous dexmedetomidine versus caudal and general anesthesia (GA) in children undergoing hypospadias surgery repair.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Caudal; Dexmedetomidine; Hypospadias; Modified Objective Pain Score (MOPS); Post-operative pain.

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Conflict of interest statement

Conflict of Interests: The authors declare no competing interests.

Figures

Figure 1.
Figure 1.. CONSORT flow chart
Figure 2.
Figure 2.. Comparison of three groups in terms of crying
Figure 3.
Figure 3.. Comparison of three groups in terms of movement
Figure 4.
Figure 4.. Comparison of three groups in terms of agitation
Figure 5.
Figure 5.. Comparison of three groups in terms of posture
Figure 6.
Figure 6.. Comparison of three groups in terms of verbal signs
See this image and copyright information in PMC

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