Dexmedetomidine as an adjuvant to infraorbital block in children undergoing cleft lip surgery – A clinical comparative study

Abstract

Regional nerve blocks provide excellent analgesia in children without adverse effects. However the duration of analgesia may be limited therefore addition of adjuvants can effectively prolong the duration of analgesia. Since alpha 2 agonist effectively prolong the duration of analgesia, we conducted a randomised double blind study to evaluate the effectiveness of dexmedetomidine as an adjuvant  in infraorbital nerve block.: Eighty children of ASA grade 1 and 2, of either sex  scheduled for cleft lip repair under general anaesthesia were allocated randomly into one of two equal groups (Group B and Group D, n=40). In both group sinfraorbital nerve block was performed with 1ml of solution on each side. The B group received bupivacaine 0.25% and the D group received b upivacaine 0.25% with 0.5µg/kg dexmedetomidine. The mean duration of analgesia and number of patients receiving rescue analgesia was recorded in both groups. The intraoperative hemodynamic parameters and postoperative sedation scores were recorded. For pain and sedation scores, Mann–Whitney U-test was used. Fisher’s exact test was used for comparison of categorical data. P ≤ 0.05 was considered as the level of statistical significance. Both groups were comparable in demographic profile. The mean duration of analgesia in Group D (733±49.15 minutes) was significantly longer compared to Group B (496±28.26) (p=0.001). There was a statistically significant difference in the number of patients receiving rescue analgesics in Group B (36) and Group D(8). The number of times of rescue analgesics in Group B and Group D was 3and 1 respectively, which was statistically significant. The intraoperative and postoperative hemodynamic HR was comparable in both groups (). The sedation score in the postoperative period did not differ between the two groups.