Ultrasound-guided caudal analgesia using fentanyl versus dexmedetomidine as an adjuvant for levobupivacaine in infraumbilical pediatric surgeries
المؤلفون المشاركون
Abd al-Hamid, Hadil Majdi
Abd al-Aziz, Mayy Muhsin
Abd al-Fattah, Amr Muhammad
المصدر
Ain Shams Journal of Anesthesiology
العدد
المجلد 9، العدد 4 (31 ديسمبر/كانون الأول 2016)، ص ص. 542-548، 7ص.
الناشر
جامعة عين شمس كلية الطب قسم التخدير
تاريخ النشر
2016-12-31
دولة النشر
مصر
عدد الصفحات
7
التخصصات الرئيسية
الموضوعات
- الطب السريري
- طب الأطفال
- العلاج بالموجات فوق الصوتية
- الأدوية
- الأدوية المهدئة
- مسكنات الألم
- العمليات الجراحية
- التخدير الموضعي
- العلاج المساند
- الفنتانيل
الملخص EN
Single-shot caudal analgesia is a useful technique in controlling postoperative pain in infraumbilical pediatric surgeries, although of a limited duration.
The aim of this study was to evaluate the analgesic efficacy and rate of success when incorporating dexmedetomidine or fentanyl to levobupivacaine in ultrasound (U / S)-guided caudal block for infraumbilical surgeries.
Patients and methods This prospective, randomized, double-blinded study was conducted on 63 pediatric patients undergoing infraumbilical surgeries, allocated into three groups to receive inhalational anesthesia with an appropriately sized laryngeal mask airway, followed by U / S-guided caudal epidural block using either only 0.25% levobupivacaine (L), or incorporating it with 1 μg / kg fentanyl (LF) or 1 μg / kg dexmedetomidine (LD) in a total volume of 0.7 ml / kg.
Pain assessment using Children’s and Infants’ Postoperative Pain Scale (CHIPPS) score, time to first analgesic, and total analgesia required in the three groups and Ramsay sedation score were recorded.
Hemodynamics and any adverse effects were also documented.
Results None of the patients required intraoperative additional analgesia.
A statistically significantly lower postoperative CHIPPS values with prolonged analgesic duration and time to rescue analgesia was observed in the levobupivacaine–fentanyl and levobupivacaine–dexmedetomidine groups (275 ± 20.62 and 304.75 ± 25.2, respectively) as opposed to the levobupivacaine only group (203.1 ± 18), with an evident reduction in the total paracetamol dose required postoperatively (P<0.001).
Arousable sedation time was significantly prolonged in the levobupivacaine– fentanyl and levobupivacaine–dexmedetomidine groups.
Apart from pruritus and urine retention in the levobupivacaine–fentanyl group, no adverse events were recorded in all groups.
Conclusion Caudal levobupivacaine combined with dexmedetomidine 1 μg/kg in pediatric patients undergoing infraumbilical surgeries provides prolonged postoperative analgesia comparable to levobupivacaine–fentanyl and superior to levobupivacaine alone, with reduced postoperative analgesic requirements and extended arousable sedation time.
The use of U / S raises the safety and ensures the success of caudal block.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Abd al-Aziz, Mayy Muhsin& Abd al-Fattah, Amr Muhammad& Abd al-Hamid, Hadil Majdi. 2016. Ultrasound-guided caudal analgesia using fentanyl versus dexmedetomidine as an adjuvant for levobupivacaine in infraumbilical pediatric surgeries. Ain Shams Journal of Anesthesiology،Vol. 9, no. 4, pp.542-548.
https://search.emarefa.net/detail/BIM-762515
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Abd al-Hamid, Hadil Majdi…[et al.]. Ultrasound-guided caudal analgesia using fentanyl versus dexmedetomidine as an adjuvant for levobupivacaine in infraumbilical pediatric surgeries. Ain Shams Journal of Anesthesiology Vol. 9, no. 4 (Oct. / Dec. 2016), pp.542-548.
https://search.emarefa.net/detail/BIM-762515
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Abd al-Aziz, Mayy Muhsin& Abd al-Fattah, Amr Muhammad& Abd al-Hamid, Hadil Majdi. Ultrasound-guided caudal analgesia using fentanyl versus dexmedetomidine as an adjuvant for levobupivacaine in infraumbilical pediatric surgeries. Ain Shams Journal of Anesthesiology. 2016. Vol. 9, no. 4, pp.542-548.
https://search.emarefa.net/detail/BIM-762515
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references : p. 548
رقم السجل
BIM-762515
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
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