Analgesic efficacy of bupivacaine alone versus bupivacaine plus dexmedetomidine in penile block for hypospadias surgery

Hypospadias is a common pediatric surgical procedure. Early postoperative pain management is essential to inhibit pain impulses and endocrine responses leading to decreased mortality and morbidity and lower rate of agitation and faster return to normal functional status. Accordingly in this study the analgesic efficacy of bupivacaine alone versus bupivacaine plus dexmedetomidine in penile block for Hypospadias surgery was determined. In this randomized clinical trial, 64 children under Hypospadias surgery in a referral center in Tehran, Iran in 2018 were enrolled and randomly assigned to receive either bupivacaine 0.25% alone 0.2 ml/kg or bupivacaine 0.25% 0.2 ml/kg plus dexmedetomidine 0.3 μg/kg. After block, the patients were reversed and extubated after complete consciousness. Patients were followed-up to 24 hour for pain according to FLACC and also the analgesia and block duration. Mean analgesia duration was 2.03 ± 0.5 and 2.63 ± 0.9 hours in combination and alone group, respectively with significant difference (P=0.003). The mean duration of block was significantly longer in combination group (P=0.001). According to the results it may be concluded that addition of dexmedetomidine to bupivacaine in hypospadias surgeries would result in longer analgesia and block duration; without addition of adverse effects.Key words: Hypospadias, Penile Block, Pediatric, Surgery