Dexmedetomidine (DEXM) is a highly selective α2-adrenoceptor agonist that has been used
increasingly in pediatric anesthesia. This prospective double blinded randomized comparative
study is designed to evaluate the analgesic effect of caudal increasing doses of DEXM 0.5 , 1
, 1.5 , 2µg/kg combined with Levobupivacaine (Levob) 0.125% (ED95% =125%=least effective
concentration) in providing pain relief over a 24-h period and lowest surgical stress peak.
Study hypothesis: Levobupivacaine 0.125 %( ED95) combined with different increasing doses of
dexamedatomedine >1 µg/kg could not add more analgesic & stress response obtundation outcome,
but increase side effects (sedation and hemodynamic depression). The peak cortisol level
during urology surgery was at the end of the 1st postoperative (PO) hour. Aim of the Study:
To detect the optimal analgesic and safe caudal adjuvant DEXM dose associated with the least
side effects& stress response modulation, guided by PO Cortisol peak difference in between
the study groups during pediatric hypospadias surgery.