Key result
Adding IV dexamethasone to caudal block extends postoperative analgesia by ~43% versus block alone.
Why the study?
The effect of adding intravenous dexamethasone to caudal block on postoperative analgesia duration and quality in pediatric lower abdominal surgeries was evaluated.
Does intravenous dexamethasone added to caudal block improve the duration and quality of postoperative analgesia in pediatric patients undergoing lower abdominal surgeries?
RCT (n=74)
Computer generated numbers
No
Does intravenous dexamethasone added to caudal block improve the duration and quality of postoperative analgesia in pediatric patients undergoing lower abdominal surgeries?
Absolute Event Rate: 7.77% vs 5.44%
p-value: p=<0.05
The addition of intravenous dexamethasone to caudal block significantly prolongs the duration of postoperative analgesia in pediatric patients undergoing lower abdominal surgeries.
IV dexamethasone may prolong caudal analgesia in pediatric lower abdominal surgery; leaves open confirmation before practice change.
dexamethasone to a caudal block in enhancing the duration and quality of postoperative analgesia in pediatric patients undergoing lower abdominal surgeries. Methodology: This Randomized Control Trial was carried out Department of Anesthesia, Holy Family Hospital, Rawalpindi from December 2021May 2022. Patients fulfilling inclusion criteria were divided into two groups. Both groups received caudal block with 1 ml/kg of 0.25% Bupivacaine while group A received 0.25 mg/kg of Dexamethasone intravenously as an adjuvant. Post operatively patients were assessed by FLACC scores at different time intervals. All surgeries were conducted under general anesthesia with endotracheal intubation. Either Mapleson F (Jackson Rees Modification of Ayre’s T piece) or circle system used as breathing circuit. Induction of anesthesia using propofol at a dose of 2-2.5 mg/kg along with O2 100% or with sevoflurane 2 to 3% at fresh gas flow of 6 L/minute was carried out. Data was analyzed using SPSS 26.0. Results: Mean duration of analgesia in Group A was 7.77 ± 1.38 hours while it was 5.44 ± 0.91 hours in group B. The difference was statistically significant with a p value of less than 0.05 on Mann Whitney U test. Conclusion: Addition of intravenous dexamethasone to caudal block significantly enhances the duration and quality of analgesia among pediatric patients undergoing lower abdominal surgeries.
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Anwar et al. (2024) conducted an RCT in Pediatric lower abdominal surgeries (n=74). Intravenous Dexamethasone with Caudal Block vs. Caudal Block alone (1 ml/kg of 0.25% Bupivacaine + IV normal saline) was evaluated on Duration of analgesia (p=<0.05). Addition of 0.25 mg/kg intravenous dexamethasone to a caudal block significantly prolonged the mean duration of postoperative analgesia to 7.77 hours compared to 5.44 hours with caudal block alone.
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