Effect of Dexamethasone as an Adjunct on Efficacy of Ropivacaine in Caudal Block for Postoperative Analgesia in Paediatric Infra-umbilical Surgeries: A Randomised Double-blind Controlled StudyCorrespondence Address :
Dr. Surendra Kumar Sethi,
Flat No. 202, Shiv Enclave, Civil Lines, Ajmer, Rajasthan, India.
E-mail : email@example.com
Introduction: Caudal block is a routinely performed analgesic and anaesthetic technique in paediatric population undergoing various infra-umbilical surgeries. Various adjuvants have been used along with local anaesthetics like ropivacaine in singleshot caudal block for enhancing postoperative analgesia in paediatric infra-umbilical surgeries.
Aim: To evaluate the efficacy of dexamethasone used as an adjuvant to 0.2% ropivacaine in caudal block for postoperative analgesia in paediatric patients.
Materials and Methods: This was a randomised double-blinded controlled study conducted on 80 paediatric patients (8 months8 years), with American Society of Anaesthesiologists (ASA) physical status I or II undergoing various infra-umbilical surgeries, at a tertiary care teaching institute from April 2019 to September 2019. These total subjects were randomly allocated into two groups. Group R (n=40) administered 0.2% ropivacaine (1 mL/kg) while Group RD (n=40) administered 0.2% ropivacaine (1 mL/kg) with dexamethasone (0.1 mg/kg) in caudal block. The duration of analgesia, postoperative pain scores (Face Legs Activity Cry Consolability (FLACC) score), rescue analgesic consumption in 24 hours, haemodynamic changes and side-effects were noted. The rescue analgesic (paracetamol 15 mg/kg oral) was given whenever FLACC ≥4. Standard qualitative and quantitative tests (unpaired student t-test, Chi-square test) were used to analyse and compare the results obtained.
Results: The mean duration of analgesia was significantly longer in Group RD (745.21±146.91 minutes) as compared to Group R (440.38±76.44 minutes); (p-value <0.001). The significantly lower FLACC pain scores were noted in patients in Group RD compared to Group R; (p-value <0.05). The rescue analgesic consumption was significantly lesser in Group RD in terms of requirement of number of doses of rescue analgesic than in Group R; (p-value <0.05). No significant haemodynamic changes or side-effects were observed in both groups; (p-value >0.05). Amongst postoperative complications noted, fever was observed in 1 patient (3.33%) and Postoperative Nausea and Vomiting (PONV) in 2 patients (6.66%) in Group R. None complications were observed in the patients of RD group.
Conclusion: Dexamethasone (0.1 mg/kg) was found to be safe and effective adjuvant to 0.2% ropivacaine for caudal block in children undergoing various infra-umbilical surgeries.
Adjuvants, Duration of analgesia, Face legs activity cry consolability scale, Local anaesthetics, Rescue analgesic
Date of Submission: Nov 11, 2020
Date of Peer Review: Jan 25, 2021
Date of Acceptance: Feb 11, 2021
Date of Publishing: May 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes (from parents)
• For any images presented appropriate consent has been obtained from the subjects. NA
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• Plagiarism X-checker: Nov 12, 2020
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