Abstract: Objective To investigate the effect of caudal dexmedetomidine(Dex) combined with ropivacaine on laparoscopic inguinal hernia surgery in children. Methods Fifty-two children undergoing inguinal hernia surgery were divided randomly into two groups with 26 cases in each. After intravenous induction each patient received a single caudal dose: group A(n=26) received 0.25% levobupivacaine(1 ml/kg) plus Dex (1 μg/kg), group B(n=26) received 0.25% levobupivacaine (1 ml/kg). MAP and HR were recorded before anesthesia(T0), at 5 min after caudal block(T1), the time of skin incision(T2), the end of surgery(T3), the time of extubation(T4) and 10 min after waking up(T5). The awake time, the incidence of restlessness and restless score during recovery period, postoperative pain scale, the need for additional analgesia agents and adverse reactions were recorded. Results The HR in group A was lower at T4 than that in group B[(106±12) bpm vs (117±12) bpm](P<0.05). Compared with group B, in group A the incidence of restlessness(3.8% vs 23.1%) and restless score in recovery period[(1.9±0.6) vs (3.1±0.7)], the pain assessment scores at 4, 8, 12, 16 h after operation[(1.1±0.6) vs (2.2±0.7), (1.2±0.6) vs (3.8±0.9), (2.3±0.6) vs (4.2±0.7), (2.6±0.9) vs (3.8±0.8)] were significantly lower(P<0.05). The difference of the pain assessment scores at 2, 24 h after operation and in recovery period between two groups was not significant. The number of patients using tramadol in group B was higher than that in group A (4 vs 0) (P<0.05). No obvious adverse reactions were found in the two groups. Conclusions Compared with using ropivacaine alone, caudal Dex combined with ropivacaine for laparoscopic pediatric inguinal hernia surgery can reduce the stress response to tracheal extubation, decrease the incidence of agitation during waking-up period and prolong the duration of analgesia by ropivacaine caudal block after operation.
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