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ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 4  |  Page : 924-929

Effect of dexmedetomidine as an adjuvant to ropivacaine in ilioinguinal-iliohypogastric nerve blocks for inguinal hernia repair in pediatric patients: A randomized, double-blind, control trial


Department of Anaesthesia, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India

Correspondence Address:
Dr. Swastika Swaro
Department of Anaesthesia, IMS and SUM Hospital, SOA University, Bhubaneswar - 751 003, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aer.AER_169_18

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Background: Bulk of published data support the efficacy of dexmedetomidine for prolongation of peripheral nerve block; but most of the studies are in adults. Ample data regarding use of dexmedetomidine in setting of paediatric peripheral nerve blocks is scarce. Aim and Objective: To determine whether adding dexmedetomidine to ropivacaine in ilioinguinal-iliohypogastric nerve block prolongs postoperative analgesia in children undergoing inguinal hernia repair. Material and Methods: Sixty children of American Society of Anesthesiologist (ASA) grade I – II aged between 2-11 years scheduled for elective hernitomy were randomly allocated to receive an ultrasound guided ilioinguinal-iliohypogastric nerve block (IINB) with 0.2 ml/kg dose of plain ropivacaine 0.2% (group R; n = 30) or ropivacaine 0.2% with adjunct dexmedetomidine 1 μg/kg (group RD; n = 30).Time to first post-operative need for supplemental analgesia triggered by pain score ≥4 according to Children's and infants postoperative pain scale (CHIPPS scale) was the primary end point of study. Number of analgesic doses during first 24 hours; intraoperative hemodynamic changes; sedation; postoperative adverse effects were noted. Results: The mean duration of analgesia was significantly prolonged in group RD (970.23 ± 46.71minutes) as compared to group R (419.56 ± 60.6 minutes). Children in group RD had significantly lower CHIPPS score, and less number of rescue analgesic requirements during first 24 hours postoperatively. No adverse effects were recorded in any group. Conclusion: The present study concluded that combined use of ropivacaine and dexmedetomidine in IINB provided profound prolongation of post operative analgesia in children following inguinal hernia repair.


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