Effects of adding dexmedetomidine to local infiltration of bupivacaine on postoperative pain in pediatric herniorrhaphy: a randomized clinical trial

Abstract

Indirect inguinal hernia, caused by a patent processus vaginalis, is a common pathology in the first year of life, especially in low-birth weight male neonates [1]. Surgery (inguinal herniorrhaphy) is considered to be the first-line treatment, in which various techniques, such as open and laparoscopic procedures, have been proposed [2]. Nevertheless, despite the variety of techniques proposed for correction of inguinal hernia, herniorrhaphy is associated with severe adverse effects, such as recurrence, and persistent postoperative pain [3,4].

Dexmedetomidine versus clonidine adjuvants to levobupivacaine for ultrasound‐guided transversus abdominis plane block in paediatric laparoscopic orchiopexy: Randomized, double‐blind study

“…No serious adverse effects were recorded throughout our study. These findings are equivalent to most of the studies using these drugs as an adjuvant to LA in various types of blocks (Azemati et al., 2019; Mostafa, Aal, et al., 2020; Ragaa et al., 2019). Dexmedetomidine was found to significantly increase sedation and analgesia and decrease blood pressure and HR in a concentration‐dependent manner because of its potent analgesic, sedative and sympatholytic properties (Ho et al., 2005; Kanazi et al., 2006; Mostafa, Herdan, et al., 2020).…”

“…The findings of higher parents’ satisfaction scores in this study that were significant in the dexmedetomidine‐treated group compared to the LA‐only group add to the superior analgesia and sedation profile of this drug when used as an adjuvant to LA in the paediatric population (Azemati et al., 2019). The current study showed that the average SpO 2 , MAP, HR and EtCO 2 levels recorded over time for all patients in the three study groups were stable and within the acceptable limits in these settings, with no noticeable statistically significant difference among the groups.…”

Dexmedetomidine Addition For Pediatric Hernia Repair: A Meta-Analysis of Randomized Controlled Studies

“…315 potentially relevant articles are identi ed initially. Finally, six RCTs are included in the meta-analysis [11,13,[17][18][19]25].…”

“…The dose of dexmedetomidine ranged from 0.3 µg/kg to 1.0 µg/kg. Among the six included RCTs, two trials reported analgesic consumption [19,25], two trials reported number of rescue analgesics and time to rst analgesia [18,19], two trials reported emergence agitation [18,25], as well as two trials reported pain scores at 1 h and 2 h [17,19]. Jadad scores of the six included studies vary from 3 to 5, and all six studies have high-quality based on the quality assessment.…”

“…Recently, several studies have investigated the e cacy of dexmedetomidine supplementation for pediatric hernia repair, but the results are con icting [11,[17][18][19]. This systematic review and metaanalysis of RCTs aims to assess the impact of dexmedetomidine supplementation on pain control after pediatric hernia repair.…”