Intra-operative and post-operative caudal analgesia with 0.125% bupivacaine and dexmedetomidine using single shot 20G IV cannula technique

Abstract

Optimal perioperative analgesia is essential in paediatric anaesthesia, particularly for acute postoperative pain following lower thoracic, abdominal, and urological surgery. This prospective observational study evaluated the efficacy and adverse effects of single-shot caudal epidural analgesia using 0.125% bupivacaine combined with dexmedetomidine in children undergoing elective urological surgery. Sixteen paediatric patients aged 3–15 years (mean age 7.5±4.1 years) with ASA physical status I–IV were included. Following induction of general anaesthesia, a caudal block was performed using a 20G intravenous cannula, with 0.125% bupivacaine and dexmedetomidine at 1 µg/kg administered at a volume of 1 ml/kg. Descriptive statistics and Student’s t-test were used for data analysis, with p<0.05 considered statistically significant. The study included 13 male and 3 female patients, and the mean duration of analgesia was 513.7±162 minutes. No significant difference in analgesic duration was observed according to sex or type of surgical incision. Haemodynamic parameters remained stable throughout the perioperative period, and no clinically significant bradycardia or hypotension was observed. One patient experienced a transient event that resolved spontaneously. Single-shot caudal epidural analgesia using 0.125% bupivacaine combined with dexmedetomidine through a 20G intravenous cannula provided prolonged perioperative analgesia with a favourable safety profile in children undergoing elective urological surgery.