Bupivacaine vs Bupivacaine with Dexmedetomidine for the Caudal Epidural Block as an Adjuvant to General Anesthesia in Lumbosacral Surgeries

Abstract Background A caudal epidural block can be incorporated as a part of multimodal analgesia for lumbosacral spine surgeries. Utilizing a combination of different analgesic modalities, achieving better pain relief, sparing opioids and decreasing their adverse effects, it is a simple and safe technique that can be easily performed under fluoroscopy in the prone position. Using an optimal analgesic regimen provides safe and effective analgesia, reduces postoperative pain, and accelerates recovery from surgery. Aim of the Work to compare the effectiveness and safety of Bupivacaine vs. Bupivacaine and Dexmedetomidine in the fluoroscopy-guided caudal epidural block for postoperative analgesia in patients undergoing lumbosacral surgeries combined with general anesthesia. Patients and Methods The study was conducted on 60 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups; each group consisted of 30 patients. Results revealed that Fluoroscopy-guided caudal epidural block using Bupivacaine and Dexmedetomidine provided significantly prolonged postoperative analgesia and reduced the postoperative analgesic requirements as compared with Bupivacaine only in patients undergoing lumbosacral surgeries and demonstrated that both analgesic techniques are safe. Conclusion Bupivacaine and Dexmedetomidine provided significantly prolonged postoperative analgesia and reduced the postoperative analgesic requirements as compared with Bupivacaine alone in patients undergoing lumbosacral surgeries under general anesthesia and also demonstrated that both analgesic drugs are safe.