Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Anesthesia and Pain relief

In a randomized double-blind study, we examined the analgesic efficacy of caudal administration of bupivacaine alone, a combination of bupivacaine and fentanyl and a combination of bupivacaine and dexmedetomidine in (75) pediatric cancer patients aged (3 {u2013} 10 years) undergoing elective subumbilical surgery. They were allocated randomly into (3) groups ,(25) each to receive a single caudal injection of either 0.25% Bupivacaine 2 1 ml / kg3 [ group B], or 0.25% bupivacaine 2 1 ml / kg3 + Fentanyl 21 ug/ kg3 in normal saline 1 ml.[ group F] or 0.25% bupivacaine 2 1 ml / kg3 + Dexmedetomidine 21 ug/ kg3 in normal saline 1 ml.[ group D ]. There were a statistically significant difference in quality of pain relief and duration of postoperative analgesia between the three groups. As regard the duration of analgesia, Bupivacaine group (B) had the shortest mean duration of postoperative analgesia (3.92hours) while dexmedetomidine group (D) had the longest mean duration of post - operative analgesia (11.74 hours). The fentanyl group (F) had intermediate duration of analgesia (6.28 hours). Sedation score was significantly higher in group3 D3during the first 6 hours postoperatively than group "F" which was still higher than in group "B". The difference was statistically and clinically significant ( p value < 0.001).

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