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? Hypoxia has a vasodilatory effect. Healthy neonates do show autoregulation in respect of cerebral blood flow (CBF), and this may be present from an early gestational age [42]. However, evidence is increasing that in sick neonates, cerebral autoregulation is lost. In the newborn lamb, 20in of hypoxia results in the loss of autoregulation for several hours [43]. Healthy term neonates are able to normalize CBF after Oxymatrine a rise in blood pressure, but not sick term infants and all preterms; there is correlation between the elevation of blood pressure and CBF, indicating some failure of cerebral autoregulation [44]. Given that anesthetic agents impair cerebral autoregulation even at low concentrations, the necessity to control blood pressure, oxygenation, and carbon dioxide tensions during anesthesia in the vulnerable neonate that has very limited compensations is of key importance. Interest is now growing in monitors such as tissue and cerebral oximetry that can measure organ perfusion as well as the simpler cardiovascular parameters. No conflicts of interest declared. ""This randomized double-blind study was conducted to evaluate the analgesic efficacy and safety of addition of three different doses of dexmedetomidine in caudal ropivacaine compared with plain ropivacaine for postoperative analgesia in pediatric day care patients. Eighty children of American Society of Anesthesiologists grade I�CII, aged 1�C8?years, undergoing lower abdominal and perineal surgery were Liraglutide clinical trial included. Children were randomly allocated into four groups. Group 1 received 0.2% plain ropivacaine 0.75?ml��kg?1, while group 2, 3, and 4 received dexmedetomidine 0.5, 1.0, and 1.5?��g��kg?1, respectively, along with 0.2% ropivacaine 0.75?ml��kg?1. Anesthesia was induced and maintained with sevoflurane and 50% N2O in oxygen. Children were observed for postoperative pain, nausea-vomiting, agitation, sedation, and adverse effects. Rescue analgesia was provided with oral paracetamol. Postoperative analgesia was significantly prolonged in all dexmedetomidine groups as compared to plain ropivacaine group (P?BACE required rescue analgesia within first 6 postoperative hours, while none in the other three groups. None of the patients showed delayed anesthetic emergence. Four patients in the plain ropivacaine group developed agitation, while none in the dexmedetomidine groups. Patients receiving dexmedetomidine 1.5?��g��kg?1 were more sedated as compared to the other groups (P?