Comparative Analysis of Bupivacaine Versus Bupivacaine with Dexmedetomidine in Caudal Block Anesthesia

Background: Postoperative pain in pediatric patients remains a critical concern, with traditional caudal blocks using bupivacaine often providing limited analgesia duration. Adding dexmedetomidine to bupivacaine may enhance analgesic effects and improve hemodynamic stability.Objective: To compare the effectiveness of bupivacaine alone versus bupivacaine combined with dexmedetomidine in caudal anesthesia for pediatric patients undergoing perurethral cystolithotripsy.Methods: A prospective cohort study was conducted on 50 pediatric patients, aged 2 months to 7 years, divided into two equal groups. Group A received caudal bupivacaine 0.25% (1 ml/kg), and Group B received caudal bupivacaine 0.25% with dexmedetomidine (1 µg/kg). Heart rate, mean arterial pressure (MAP), respiratory rate, FLACC score, and Ramsay sedation score were recorded intraoperatively and at multiple postoperative intervals. Data were analyzed using SPSS version 25, with an independent t-test and chi-square test.Results: Group B showed significantly lower mean FLACC scores (0.80 vs. 3.08 at 60 min, p=0.024) and higher sedation scores (3.60 vs. 1.60 at 60 min, p=0.000) compared to Group A. Heart rate and MAP were more stable in Group B (p<0.05).Conclusion: Dexmedetomidine combined with bupivacaine provided superior analgesia and sedation with improved hemodynamic stability compared to bupivacaine alone.