Addition of dexmedetomidine to caudal bupivacaine in paediatric patients: Hemodynamic changes

Abstract

Neurotransmitters in the spinal cord attenuate or amplify the pain signals from the periphery. Substance P, calcitonin and gene related peptides amplify while endogenous opioids, norepinephrine, serotonin, GABA and glycine attenuate the pain signal. Nociceptive impulse reaches the thalamus by second order neurons in the spinothalamic, spinoreticular and spinomesencephalic tracts. This study included 60 children, of both genders, coming for various elective infra-umbilical surgical procedures such as herniotomy, circumcision, orchidopexy, urethroplasty etc. After obtaining clearance from the hospital ethical committee a written informed consent was obtained from parents before commencing the study. The baseline oxygen saturation (SpO2) was 98.67 ± 1.24% in group B. In group D, the baseline oxygen saturation (SpO2) was 98.17 ± 1.51%. There was no significant difference between the groups. At 5, 15 and 30 minutes SpO2 values were 99 ± 0.74%, 98.1% ± 0.89 and 97.9% ± 1.24 respectively in group B and 98.23% ± 1.4, 98.67% ± 1.18 and 98.6% ± 1.04 24 respectively in group D. The differences were statistically significant but clinically insignificant.