Addition Of Dexmedetomidine to Bupivacaine in Ultrasound Guided Erector Spinae Plane Block for Neonates Undergoing Tracheo-esophageal Fistula Repair

Abstract

Background : Assessing the effects of combining dexmedetomidine with bupivacaine in ultrasound-guided ESPB on the stress response and postoperative pain in infants having tracheoesophageal fistula surgery. The study also evaluate the impact on the incidence of postoperative respiratory complications, the length of hospital stay, and the need for additional analgesics.Settings and Design: A prospective randomized study.Methodology: With institutional Medical Ethics Committee approval, this study was conducted at El-Shatby Paediatric Hospital on 90 neonates undergoing tracheoesophageal fistula repair. The neonates were divided into two equal groups at random: Group 1 received an ultrasound-guided ESPB with 0.25% bupivacaine (0.5 ml/kg) and dexmedetomidine (0.5 μg/kg), while Group 2 received ESPB with just 0.25% bupivacaine at the same volume.Results: Group 1's postoperative pain scores were consistently lower than Group 2's during the first 24 hours after surgery. After surgery, salivary cortisol levels rose in both groups, but there was no discernible difference. In addition, compared to Group 2, Group 1 showed a significant decrease in opioid use and a longer duration of analgesia. In Group 1, the duration of stay in the NICU was considerably shorter.Conclusion: Dexmedetomidine added to local anesthetics improved postoperative analgesia, prolonged the duration of pain relief, and reduced the need for additional opioids without causing major side effects, according to this study. These findings backed up the use of dexmedetomidine as a secure and useful adjuvant in pediatric regional anesthesia.