Comparison Of The Effects Of Caudal Block With Different Doses Of Dexmedetomidine On Postoperative Analgesia After Pediatric Circumcision

Objective To compare the analgesic effect of different doses of dexmedetomidine combined with local anesthetic caudal block in children after circumcision and to explore the suitable dosage of dexmedetomidin.Methods 120 children received with circumcision in our hospital were chosen and divided into four groups using a random number table.Group R was received with 0.25% ropivacaine only by sacral block;other three groups also received the sacral block same as group R;but group DR1 was add 1 μg/kg dexmedetomidin in the local anesthetic solution;group DR2 add 2 μg/kg dexmedetomidin in the solution;then group DVR received with 0.5 μg/kg dexmedetomidin by intravenous syringe pumps.Each group had 30 cases.The FLACC scores of four groups were recorded at recovery time,2nd hour,4th hour,6th hour,12 th hour,16 hour,24 th hour of post-operation respectively.The indexes of operation time,recovery time,the restlessness score and the analgesic time were compared among four groups.The adverse events and the incidence of postoperative complications were compared among four groups.Results There was no respectively difference in operation times among the four groups(P>0.05).Comparison of the children’s recovery time in each group: DVR group was respectively longest than other three groups(P<0.05);Group DR2 was respectively longer than group R and group DR1(P<0.05);Group R and group DR1 were the shortest,but there was no respectively difference between the two groups(P>0.05).The FLACC scores of group DRV and group DR2 were shortest,and the group DR1 was the medial and the group R was the longest(P<0.05).The analgesic time of group R were shortest,and the group DR1 and the group DVR was the medial and the group DR2 was the longest(P<0.05).The FLACC scores of four groups at the recovery time,post-operation 2nd hour and 24 th hour were no different among four groups(P>0.05).At the 4th hour,6th hour,12 th hour and 16 th hour of post-operation,the FLACC scores of group DR1,group DR2 and group DVR were lower than of group R(all P<0.05),and the FLACC scores of group DR2 were lowest(all P<0.05),but the FLACC scores of group DR1 and group DVR were no different(P>0.05).The incidence of adverse events of bradycardia,hypotension and hypertension in group DVR was significantly higher than that in other groups(P<0.05).Analgesic supplements in group R were significantly higher than those in other groups(P<0.05).Conclusions In this clinic trial,it can be gain the best analgesic effect、less adverse reactions and hemodynamic stability that the caudal block with the dosage of 2 μg/kg dexmedetomidine combined with ropivacaine on postoperative analgesia follow pediatric circumcision.