الفهرس 
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Abstract
This prospective, randomized, double-blinded controlled study was conducted at EL-Minia university hospital during the period from january 2017 to January 2018. The study involved 90 patients of either sex, of ASA I and II physical status, aged (1-7) years old, and posted for unilateral infraumbilical surgeries, under ultrasound- guided transversus abdominis plane block and written informed consent from each patient was obtained.
Patients were randomly divided into three equal groups; 30 patient in each group:
group C: received ultrasound guided transverses abdominis plane block with 0.3 ml/kg of 0.25% bupivacaine plus 5ml 0.9% normal saline (placepo).
group D0.5: receive ultrasound guided transverses abdominis plane block with 0.3 ml/kg of 0.25% bupivacaine plus 0.5µg/Kg dexmeditomidine diluted in 5ml 0.9% normal saline.
group D1: receive ultrasound guided transverses abdominis plane block with 0.3 ml/kg of 0.25% bupivacaine plus 1µg/Kg dexmeditomidine diluted in 5ml 0.9% normal saline.
Our primary outcome was to study the effect of two doses of dexmedetomidine added to bupivacaine in TAP block in pediatrics undergone unilateral infraumbilical surgery on postoperative analgesia, analgesic consumption, post-operative pain score and postopertive side effects compared with bupivacaine alone.
All patients were assessed with regards to:
Hemodynamic parameters (HR, MAP) were recorded before and immediately after induction of anesthesia and then at 5, 10, 15, 20, 30 and 45 minutes, till the surgery ended, and for two hours after surgery.
Analgesic requirements: all through the procedure (by measuring the analgesic need intra operative in the form of fentanyl 0.5 µg/kg) and number of doses for each patient, and postoperatively for 24 hours by measuring pain score, analgesic requirement and analgesic consumption.
Incidence of complications: in the form of hemodynamic instability, injury to the underlying structures (injury to the liver or a viscus), and hematoma formation as recorded under ultrasound guidance.