Evaluation of caudal dexamethasone with ropivacaine for post-operative analgesia in paediatric herniotomies: A randomised controlled study

• Published in: Indian journal of anaesthesia Vol. 60; no. 1; pp. 30 - 33
• Main Authors: Choudhary, Santosh, Dogra, Neelam, Dogra, Jaideep, Jain, Priyanka, Ola, Sandeep, Ratre, Brajesh
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow Publications 01-01-2016; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Analgesics; Anesthesia; Cardiac arrhythmia; Caudal block, dexamethasone, paediatric herniotomy, ropivacaine; Dexamethasone; Dosage and administration; Dose-response relationship; Drug dosages; Electrocardiography; Hernia repair; Methods; Narcotics; Nausea; Original; Pain management; Patients; Pharmacological research; Postoperative period; Studies; Surgery; Vomiting; dexamethasone; ropivacaine; Caudal block; paediatric herniotomy
• ISSN: 0019-5049; 0976-2817
• DOI: 10.4103/0019-5049.174804

Background and Aims: Caudal analgesia is one of the most popular regional blocks in paediatric patients undergoing infra-umbilical surgeries but with the drawback of short duration of action after single shot local anaesthetic injection. We evaluated whether caudal dexamethasone 0.1 mg/kg as an adjuvant to the ropivacaine improved analgesic efficacy after paediatric herniotomies. Methods: Totally 128 patients of 1-5 years age group, American Society of Anaesthesiologists physical status I and II undergoing elective inguinal herniotomy were randomly allocated to two groups in double-blind manner. Group A received 1 ml/kg of 0.2% ropivacaine caudally and Group B received 1 ml/kg of 0.2% ropivacaine, in which 0.1 mg/kg dexamethasone was added for caudal analgesia. Post operative pain by faces, legs, activity, cry and consolability tool score, rescue analgesic requirement and adverse effects were noted for 24 h. Results: Results were statistically analysed using Student's t-test. Pain scores measured at 1, 2, 4, and 6 h post-operative, were lower in Group B as compared to Group A. Mean duration of analgesia in Group A was 248.4 ± 54.1 min and in Group B was 478.046 ± 104.57 min with P = 0.001. Rescue analgesic requirement was more in Group A as compared to Group B. Adverse effects after surgery were comparable between the two groups. Conclusion: Caudal dexamethasone added to ropivacaine is a good alternative to prolong post-operative analgesia with less pain score compared to caudal ropivacaine alone.