This study aims to evaluate if adding dexmedetomidine to bupivacaine in a caudal block can provide longer and better quality pain relief for children after open appendectomy surgery. The study will also assess the effect of this combination on the quality of recovery, including the incidence of emergence delirium, and its overall safety profile.
ASA (American Society of Anesthesiologists) physical status I or II.
Legal guardian provides written informed consent.
Refusal of participation by the legal guardian.
Known allergy or hypersensitivity to local anesthetics or dexmedetomidine.
Coagulation disorder or receiving anticoagulant therapy.
Active infection at or near the injection site.
Parallel
caudal block using dexmedetomidine with bupivacaine
Procedure/SurgeryPatients will receive a single-shot caudal block with 1 mL/kg of 0.25% bupivacaine mixed with 1 µg/kg of dexmedetomidine (diluted in 1 mL of normal saline).
caudal block with bupivacaine
Procedure/SurgeryPatients will receive a single-shot caudal block with 1 mL/kg of 0.25% bupivacaine mixed with 1 mL of normal saline
Time to First Rescue Analgesia:
Defined as the time interval in minutes from the performance of the caudal block until the first administration of rescue analgesia (ibuprofen), which is prompted by a FLACC pain score of ≥ 4.
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