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Category: Volume 07 Issue 11 November 2019
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Title: Effect of Intravenous Dexamethasone Combined with Caudal Block on Post Operative Analgesia in Children Undergoing Infraumblical Surgeries

Authors: Fauzia Shifaat, Arshi Taj , Shazada Gani

 DOI: https://dx.doi.org/10.18535/jmscr/v7i11.34

Abstract

Background: Caudal block is the most commonly used technique providing intra and postoperative analgesia for various pediatric Infraumblical surgical procedures, but with the disadvantage of short duration of action after single injection.

Objective: The objective of this study was to examine the effects of single dose i.v Dexamethasone in combination with caudal block for post operative analgesia in children undergoing Infraumblical surgeries.

Methods: This was a prospective randomized controlled study conducted in patients aged between 1- 6 years scheduled for Infraumblical surgeries. A total of   Sixty patients were randomized into two groups. Group A received i.v 0.25 mg/kg Dexamethasone in 5ml solution, where as Group B received an equivalent volume of i.v normal saline. All patients received caudal block with 1ml/kg of 0.2% ropivacaine. Postoperative pain was assessed and recorded in these patients using time to rescue analgesia, pain scores and adverse effects (if any), were documented for 24 hrs post operatively. Data were analyzed using SPSS IBM software version 21 (IBM SPSS Advanced Statistics; Chicago, IL, USA).   

Results: A total of sixty patients were analyzed with a mean age of (4.3±2.1) and (3.9±2.6) years in the groups A and B respectively. Time to rescue analgesia (TRA) was 635 min and 410 min in Group A and Group B respectively (p<0.05). Postoperatively there was statically significant difference in the pain scores between the two groups at the end of surgery (0 hrs) , 30min,  1 hr, 2hrs, 4hrs, 6hrs, 8hrs, 12hrs and 24hrs after surgery (p<0.05). Analgesic consumption within 24hrs post operatively was also low in Dexamethasone group as compared to control group with statically significant differences (p<0.05).  

Conclusions: The use of Intravenous Dexamethasone 0.25 mg/kg in combination with a caudal block prolonged the duration of analgesia, reduced pain score and analgesic consumption postoperatively in Children undergoing Infraumblical  surgeries in children.

Keywords:  caudal; analgesia, postoperative pain; Dexamethasone; paediatric surgeries, Infraumblical surgeries.

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Corresponding Author

Dr Fauzia Shifaat

Assistant Professor, Department of Anesthesiology & Critical Care, Govt. Medical College, Srinagar, India