A Comparative Study of Dexmedetomidine and Tramadol as an Adjuvant to Levobupivacaine in Ultrasound Guided Transverse Abdominus Plane Block in Pediatric Patients Undergoing Laproscopic Orchidopexy

Background: Transverse abdominus plane (TAP) block is a regional anesthetic technique which provides an excellent analgesia without major adverse effects. The primary aim of this study was to evaluate the efficacy of dexmedetomidine in comparison to tramadol when added as adjuvant to levobupivacaine in TAP block on duration of post operative analgesia following laproscopic orchidopexy. Methods: Sixty American Society of Anaesthesiologists (ASA) grade 1 pediatric patients undergoing laproscopic orchidopexy under general anaesthesia were randomized into two groups (GroupLD and Group LT). Group LD recieved ultrasound guided bilateral TAP block with 0.3 ml/kg 0.25% levobupivacaine with 1µg/ kg of dexmedetomidine on both sides and Group LT recieved TAP block with 0.3 ml/kg 0.25% levobupivacaine with 1mg/ kg of tramadol. During the first 24 h postoperatively, we assessed hemodynamic stability, respiratory depression, and postoperative pain using face, legs, activity, cry, consolability (FLACC) pain scale. Results: Total duration of analgesia (986.67 ± 47.29 min vs. 690 ± 53.49 min, P value- 0.000), and the total consumption of paracetamol in the first 24 hours postoperatively (324.28 ± 35.5 mg vs. 580.14 ± 38.23, P value – 0.000) were statistically highly significant in group LD in comparison to group LT. The FLACC score were lower in Group LD as compared to group LT and side effects profile were similar in both the groups. Conclusion: Dexmedetomidine in a dose of 1 μg.kg-1 when added to levobupivacaine in ultrasound guided transverse abdominus plane block significantly prolongs the duration of postoperative analgesia as compared to tramadol with levobupivacaine without major side effects.