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Analgesic efficacy of caudal dexamethasone combined with ropivacaine in children undergoing orchiopexy
Journal article   Peer reviewed

Analgesic efficacy of caudal dexamethasone combined with ropivacaine in children undergoing orchiopexy

E. M. Kim, J. R. Lee, B. N. Koo, Y. J. Im, H. J. Oh and J. H. Lee
British journal of anaesthesia : BJA, Vol.112(5), pp.885-891
05/01/2014
DOI: 10.1093/bja/aet484
PMID: 24491414
url
http://bja.oxfordjournals.org/content/112/5/885.longView
Open Access

Abstract

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.
 Anesthesiology Life Sciences & Biomedicine Science & Technology

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