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Background and Aims We aimed to compare the effects and potential side effects of two different doses of dexmedetomidine, added as an adjuvant to bupivacaine in the QLB, on the time to first rescue analgesia requirement within the first 24hours postoperatively, postoperative pain scores, analgesic consumption, hemodynamic parameters, postoperative sedation, and agitation scores in pediatric patients undergoing inguinal region surgery.

Methods A prospective, double-blind, randomized controlled study was conducted, including 60 patients aged between 1 and 7years undergoing inguinal region surgery. The QLB was performed in GroupI with bupivacaine only(0.25%,0.5ml/kg), in Group II added 0.5 μg/kg, and in GroupIII added 1μg/kg dexmedetomidine. Perioperative hemodynamic parameters, postoperative Ramsey Sedation and Watcha Behavior Scale, FLACC score within the first 24 hours, time to first analgesic requirement, and the amount of additional analgesic given were recorded.

Results The time to request the first rescue analgesia was significantly prolonged in groupII and III[Mean±SD(95% CI)] 1128± 98.6(921.5-1334) and 1200±81.2(1030-1370) min. vs groupI 758±99.6(499.5-916.5) min.,p 0.001). We did not find a significant difference in the time to first rescue analgesia between Groups II and III. There was a significant decrease in the amount of rescue analgesia consumption in GroupII and III than Group I(p=0.001). We found higher Ramsey Sedation Scale scores and lower Watcha Behavior Scale scores in GroupsII and III.

Conclusions Both doses of dexmedetomidine similarly have been shown to prolong the duration of analgesia, reduce postoperative pain scores and decrease the need for rescue analgesics. Therefore, the 0.5 μg/kg dose may be a good alternative to higher doses of dexmedetomidine.