Comparison Between Bupivacaine and Bupivacaine With Dexmedetomidine in Caudal Block for Post Operative Pain Control
Condition: Post Operative Pain
MeSH terms: Pain, Postoperative
Study type: Interventional
Phase: Phase 4

Summary: 
      The aim of this study is to compare the duration of analgesia, sedation, and intra and
      postoperative hemodynamics. This drug is recently available in Pakistan. To the best of our
      knowledge, no published data is available in this respect in Pakistan, so this study would in
      turn help to fill the gap in knowledge in low-resource settings/emerging economy.
    

Detailed description: 
      Postoperative pain is an annoying subjective sensation for both children and their parents.
      Almost 80% of the patients undergoing surgery experience postoperative pain, and 80% of them
      reported moderate to severe pain intensity. Management of postoperative pain has become a
      major concern in pediatrics. Results of many studies in different countries show that
      postoperative pain in children is inadequate. Lee et al showed that one of the main reasons
      for inadequate treatment of postoperative pain in children is difficulties with pain
      assessment and concerns related to the side effects of opioid analgesics.

      The regional anesthetic technique significantly decreases postoperative pain and systemic
      analgesic requirements. Caudal block, usually combined with general anesthetic technique is
      one of the most popular, reliable, and safe anesthesia techniques for abdominal and lower
      limb surgeries in children but the main disadvantage of caudal analgesia is the short
      duration of action after a single injection.

      Bupivacaine is a long-acting, reliable local anesthetic agent that is used as a caudal
      analgesic, but different auxiliary agents need to be co-administered to improve its analgesic
      efficiency. Various additives used in the past to increase the pain-free period
      postoperatively and to decrease the analgesic requirement such as midazolam neostigmine,
      ketamine, clonidine, and dexmedetomidine.

      Dexmedetomidine is a potent and highly selective alpha 2 adrenergic agonists that has been
      described as safe and effective in many anesthetic applications and analgesic techniques. In
      contrast to other agents, it has sympatholytic, analgesic, and sedative effects, and is
      randomly free from side effects except for manageable hypotension and bradycardia.
    

Intervention name(s): Bupivacaine Hydrochloride 0.25% Injection Solution; Bupivacaine Hydrochloride 0.25% Injection plus Dexmedetomidine 1 microgram/kg body weight
Intervention type(s): Drug; Drug
Intervention description(s): Bupivacaine Hydrochloride 0.25% Injection Dose: 1mL/kg (milliliter per kilogram body weight); Bupivacaine HCL 0.25% Injection plus Dexmedetomidine 1micro/kg Dose: 1 mL/kg (milliliter per kilogram body weight)
Intervention MeSH terms: Dexmedetomidine; Bupivacaine
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: comparative study
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Supportive Care