Introduction: Administration of optimum anesthesia in infants undergoing surgeries is challenging. There is a debate over the cost and benefits of each used anesthetic agent in the literature. In this study, we aimed at identification of the optimum dose of dexmedetomidine as an adjuvant to Bupivacaine for Infants undergoing infra-umbilical surgeries. Methods: In a comparative randomized controlled trial, we included 92 infants who underwent infra-umbilical surgeries. Patients were divided into four groups according to the received anesthesia. Group 1 received spinal anesthesia with bupivacaine 0.5% only; group 2 received Dexmedetomidine 0.25 μg/kg as an adjuvant to bupivacaine 0.5%; group 3 received Dexmedetomidine 0.3 μg/kg as an adjuvant to bupivacaine 0.5%; group 4 received Dexmedetomidine 0.4 μg/kg as an adjuvant to bupivacaine 0.5%. We assessed onset and duration of sensory and motor block, postoperative pain, and postoperative need for rescue analgesia. Results: A dose of 0.3 μg/kg dexmedetomidine in addition to bupivacaine was associated with the best outcomes regarding level of sedation, and postoperative pain scores. Conclusions: Dexmedetomidine is a good adjuvant to bupivacaine in infants surgeries; specifically the dose of 0.3 μg/kg.

Dexmedetomidine, Infra-Umbilical Surgeries, Bupivacaine, spinal anesthesia