Comparative study between caudal dexmedetomidine with bupivacaine versus ketamine with bupivacaine for postoperative analgesia after inguinoscrotal surgery in pediatric patients

Objectives : The aim of this randomized, double-blinded study was to compare the duration of postoperative analgesia and sedation, and the incidence of any side effect of single-dose caudal dexmedetomidine with bupivacaine versus ketamine with bupivacaine in pediatric patients undergoing inguinoscrotal surgeries. Patients and methods A total of 60 pediatric patients, 2–5 years of age, American Society of Anesthesiologists physical status I or II, scheduled for inguinoscrotal surgeries were included in the study. The patients were divided into two equal groups: group A patients (n = 30) received dexmedetomidine with bupivacaine, whereas group B patients (n = 30) received ketamine with bupivacaine. For each patient, postoperative sedation score, pain score, duration of analgesia, and postoperative complications were recorded. Results The duration of postoperative analgesia was longer in group A than in group B, and sedation score was lower in group B than in group A, which was statistically signifi cant. No signifi cant postoperative complications were recorded in both groups. Conclusion The use of dexmedetomidine, as an additive to the local anesthetic bupivacaine in caudal epidural analgesia, during single-dose injection, prolonged the duration of postoperative analgesia following inguinoscrotal surgery compared with caudal administration of ketamine with bupivacaine, but with more sedation compared with ketamine. Both groups showed few side effects.