Intraoperative Hemodynamic Changes in Dexamethasone and Magnesium Sulphate as an Adjunct to Bupivacaine for Caudal Blockade Anesthesia and Analgesia in Children Undergoing Lower Abdominal Surgeries

Abstract

Background: It is possible to achieve caudal analgesia by administering a little amount of local anesthetic into the caudal canal. There have been good analgesic effects reported for Dexamethasone with Magnesium Sulfate.

Objective: The aim of the work was to evaluate and compare between dexamethasone and magnesium sulphate regarding duration and first time of rescue analgesic requirement intraoperative and to measure intraoperative hemodynamic changes (MAP, HR, SPO₂) sedation and the amount of sedative and analgesic required.

Patients and Methods: Pediatric patients aged 2 to 6 years of both genders were included in this Randomized double blind clinical study. They were all scheduled for Lower Abdominal Surgeries. Before surgery, a computer-generated randomization table randomly assigned patients into two dexamethasone (D) and magnesium (M) groups, each were 20. Caudal block was administered to patients in Group D using dexamethasone 0.1mg/kg in conjunction with bupivacaine 0.25% at 2mg/kg. Group M: patients received a 0.25 percent bupivacaine/magnesium sulphate caudal block of 5mg kg. The patients were submitted to clinical evaluation, laboratory investigations and monitoring pre and intraoperative hemodynamic changes.

Results: Regarding demographic data, there was no significant difference between both groups (P > 0.05). Regarding HR distribution at different times pre and intraoperatively, there was no significant difference between both groups (p value >0.05). Regarding mean arterial blood pressure (MAP) at different times pre and intraoperatively, there was no significant difference between both groups (p value >0.05). Regarding the arterial oxygen saturation at different times, there was no statistical significant difference between both groups (p value >0.05).

Conclusion: The analgesic profile of bupivacaine-induced caudal blocking children undergoing lower abdominal surgery was improved with magnesium (5 mg/kg) and Dexamethasone (0.1mg/kg).