The effects of dexmedetomidine added to bupivacaine forparasternal intercostal block in pediatric open heart surgery

Background Regional analgesia is used for pain relief after pediatric open heart surgery. This study was designed to compare the analgesic effect of dexmedetomidine added to bupivacaine in performing parasternal block after sternotomy.Patients and methodsSixty American Society of Anesthesiologists (ASA) III–IV patients who were submitted to corrective open cardiac surgery were enrolled in this study and randomly allocated either into the dexmedetomidine group in which patients were given a mixture of 0.25% bupivacaine,0.6 ml/kg and dexmedetomidine 1 μg/kg (dexmedetomidine group, n = 30) or into the control group in which patients were given 0.25% bupivacaine and 0.6 ml/kg (control group, n = 30). Postoperative pain (FLACC) scores, hemodynamics, opioid consumption, and hospital length of stay were evaluated in all patients.ResultsHeart rate, mean arterial pressure, and FLACC score were significantly lower in the dexmedetomidine group compared with the control group after 4 and 8 h in ICU. Duration of intubation and ICU stay were significantly shorter in the dexmedetomidine group compared with the control group. Ramsay sedation score was lower in the dexmedetomidine group compared with the control group at 4 h in ICU. Bradycardia and hypotension incidence were higher in the dexmedetomidine group compared with that in the control group. ConclusionAdding dexmedetomidine to bupivacaine for parasternal block in pediatric patients submittedto open heart surgery leads to good pain control, less analgesic consumption, early extubation,and short ICU length of stay.