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The efficacy of caudal dexmedetomidine on stress response and postoperative pain in pediatric cardiac surgery.

AbstractAIMS AND OBJECTIVES:
We studied efficacy of caudal dexmedetomidine (DEX) on attenuation of perioperative stress response and postoperative pain in pediatric patients undergoing cardiac surgery.
MATERIALS AND METHODS:
Forty patients, (ASA II, III), 1-3-years old were randomly allocated into two groups; group BD received caudal bupivacaine 0.25%, 2.5 mg/kg and DEX 0.5 μg/kg and group BF received bupivacaine 2.5 mg/kg and fentanyl 1 μg/kg.
RESULTS:
Serum cortisol and blood glucose levels increased in both groups but increases were significantly less in group BD. Poststernotomy cortisol level (ug/dl) was 55.3 ± 5.1 vs. 90.4 ± 6.5; after cardio-pulmonary bypass (CPB) 84.1 ± 6.2 vs. 153.1 ± 8.5; after operation 78.3 ± 8.1 vs. 150.2 ± 9.8. Poststernotomy blood glucose level (mg/dl) was 93.6 ± 7.2 vs. 125.6 ± 5.5; after CPB 115.3 ± 3.7 vs. 175.3 ± 10.4; and after operation 97.3 2 ± 3 vs. 162.2 ± 12. Heart rate and mean arterial pressure decreased significantly after caudal block in group BD relative to the baseline and compared with group BF ( P < 0.05). Group BD had lower pain scores at first hour 2 ± 0.7 vs. 3 ± 1.1 ( P = 0.04); second hour 1.9 ± 0.5 vs. 3.7 ± 0.8, ( P = 0.008); fourth hour 2.4 ± 0.8 vs. 4.3 ± 0.5 ( P = 0.03); and eighth hour 2.5 ± 0.5 vs. 4.2 ± 1.1 ( P = 0.03).
CONCLUSIONS:
Caudal DEX attenuated stress response to surgical trauma and provided better postoperative analgesia.
AuthorsDalia Abdelhamid Nasr, Hadeel Magdy Abdelhamid
JournalAnnals of cardiac anaesthesia (Ann Card Anaesth) 2013 Apr-Jun Vol. 16 Issue 2 Pg. 109-14 ISSN: 0974-5181 [Electronic] India
PMID23545865 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Adrenergic alpha-2 Receptor Agonists
  • Blood Glucose
  • Dexmedetomidine
  • Hydrocortisone
Topics
  • Adrenergic alpha-2 Receptor Agonists (therapeutic use)
  • Anesthesia, Caudal
  • Blood Glucose (analysis)
  • Cardiac Surgical Procedures
  • Child, Preschool
  • Dexmedetomidine (therapeutic use)
  • Humans
  • Hydrocortisone (blood)
  • Infant
  • Pain, Postoperative (drug therapy)
  • Prospective Studies
  • Stress, Psychological (prevention & control)

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