AbstractIntroduction: In paediatric patients, optimum pain relief is a big challenge. An effective therapy to block or modify the physiological responses to painful stimuli is essential. Hence, here is an attempt to study the addition of dexmedetomidine, an alpha-2 adrenergic receptor agonist to bupivacaine with regard to analgesic potency and side effects. Material and Methods: After approval from the institution's ethics committee, the study was conducted to compare the effect of the addition of dexmedetomidine to bupivacaine in a caudal block for postoperative analgesia in paediatric infra-umbilical surgeries. Written informed parental or guardian consent was obtained.30 cases in the age group of 1 to 6 years were studied. They were randomly divided into two groups, Group N and Group D. • Group N (n=30) – 0.25% Bupivacaine 1 ml/kg+ 0.5 ml normal saline • Group D (n=30) – 0.25% Bupivacaine 1 ml/kg+Dexmedetomidine 1 μg/kg, making the volume to 0.5 ml. The total volume for the caudal block was 1 ml/kg in both groups. • after giving general anaesthesia child was placed in the left lateral position and a caudal block was performed under sterile conditions. The postoperative pain relief was evaluated using FLACC score hourly for the first 6 hours, 2 hourly up to 12 hours and then 4 hourly up to 24 hours. Sedation is evaluated by Ramsay's sedation score. Results and Conclusion: The addition of dexmedetomidine in the dose of 1µg/kg to 0.25% bupivacaine for caudal blockade showed that the duration of analgesia for Group N was 5.86±1.21 hrs and Group D was 15.5±3.02 hrs, without any significant haemodynamic changes, safe for use in paediatric patients without any adverse effects.