A STUDY TO COMPARE CAUDAL DEXMEDETOMIDINE VERSUS FENTANYL AS ADJUVANT TO 0.25% LEVOBUPIVACAINE FOR POSTOPERATIVE SEDATION IN PAEDIATRIC PATIENTS UNDERGOING INFRAUMBLICAL SURGERIES UNDER GENERAL ANAESTHESIA

Background: Caudal analgesia reduces the amount of inhaled and intravenous (i.v.) anaesthetic requirement, attenuates the stress response to surgery, facilitates a rapid, smooth recovery and provides good post operative analgesia and sedation. Methods: 135 patients of either sex, aged between 2 to 8 years, having body weight 10 to 30kg belonging to ASA Grade I and II scheduled for infraumblical surgeries under GA were randomized into three groups of 45 each to receive the caudal block i.e Group A received .25% levobupivacaine (.75ml/kg) with 0.9%NS. Group B received .25%levobupivacaine (.75ml/kg) with fentanyl 1mcg/kg diluted with 0.9%NS upto 1ml and Group C received 0.25%levobupivacaine (0.75ml/kg) with dexmedetomidine 1mcg/kg diluted with 0.9%NS upto 1ml. Results: There was statistically insignificant difference in the socio- demographic variables in terms of age, weight, sex ratio, ASA Grade and duration of surgery among the study groups. There was statistically significant (p<0.05) prolongation in the duration of arousable sedation, recorded using the Ramsay sedation score in Group C(up to 4hrs), in contrast to Group A( up to 1hrs) and Group B(up to 2hrs). Conclusion: The mean ramsay sedation score was significantly greater in the group levobupivacaine with dexmedetomidine as compared to levobupivacaine alone and levobupivacaine with fentanyl group. Keywords: Ramsay sedation score, Levobupivacaine, Dexmedetomidine, Caudal analgesia.