Analgesic efficacy of caudal dexamethasone combined with ropivacaine in children
undergoing orchiopexy.
Author(s): Kim EM(1), Lee JR, Koo BN, Im YJ, Oh HJ, Lee JH.
Affiliation(s): Author information:
(1)Department of Anesthesiology and Pain Medicine, Yonsei University College of
Medicine, 50 Yonsei-ro, Seodaemun-gu, 120-752 Seoul, Republic of Korea.
Publication date & source: 2014, Br J Anaesth. , 112(5):885-91
BACKGROUND: Epidural administration of dexamethasone might reduce postoperative
pain in adults. We evaluated whether a caudal block of 0.1 mg kg(-1)
dexamethasone combined with ropivacaine improves analgesic efficacy in children
undergoing day-case orchiopexy.
METHODS: This randomized, double-blind study included 80 children aged 6 months
to 5 yr who underwent day-case, unilateral orchiopexy. Patients received either
1.5 ml kg(-1) of 0.15% ropivacaine (Group C) or 1.5 ml kg(-1) of 0.15%
ropivacaine in which dexamethasone of 0.1 mg kg(-1) was mixed (Group D) for
caudal analgesia. Postoperative pain scores, rescue analgesic consumption, and
side-effects were evaluated 48 h after operation.
RESULTS: Postoperative pain scores at 6 and 24 h post-surgery were significantly
lower in Group D than in Group C. Furthermore, the number of subjects who
remained pain free up to 48 h after operation was significantly greater in Group
D [19 of 38 (50%)] than in Group C [four of 37 (10.8%); P<0.001]. The number of
subjects who received oral analgesic was significantly lower in Group D [11 of 38
(28.9%)] than in Group C [20 of 37 (54.1%); P=0.027]. Time to first oral
analgesic administration after surgery was also significantly longer in Group D
than in Group C (P=0.014). Adverse events after surgery including vomiting,
fever, wound infection, and wound dehiscence were comparable between the two
groups.
CONCLUSIONS: The addition of dexamethasone 0.1 mg kg(-1) to ropivacaine for
caudal block can significantly improve analgesic efficacy in children undergoing
orchiopexy. Clinical trial registration NCT01604915.
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