Background: The present study was performed to determine and compare the analgesic effect of dexamethasone as an adjuvant to caudal block when given intravenously and caudally.
Material and Methods: This interventional, double-blinded, randomized controlled study included 165 pediatric patients aged 1-5 years with anaesthesiology (ASA) physical status I and II admitted to the hospital for elective infraumbilical surgeries. Children were allocated randomly with the chit method to three groups such that subjects in group I received caudal Bupivacaine 0.25% (1ml/kg), along with caudal normal saline (NS) 0.025ml/kg and IV NS 0.075ml/kg; group II received caudal Bupivacaine 0.25% (1ml/kg) with caudal dexamethasone 0.1 mg/Kg (0.025ml/kg) and IV NS 0.075ml/kg; group III received caudal Bupivacaine 0.25% (1ml/kg) along with caudal NS 0.025ml/kg and IV dexamethasone 0.3mg/kg (0.075ml/kg) (dexamethasone sodium phosphate vial 4mg/ml). Patients-intraoperative hemodynamic parameters were recorded every 10 minutes till the end of surgery. Postoperative pain was assessed hourly with a FLACC score until the score was>3, and the time was noted as analgesia duration. Total analgesic consumption during the first 24 hours was also noted down.
Results: In Group 1, the mean time to first rescue analgesia was 4.00\(\pm\)0.69 hours; in Group 2, it was 8.07\(\pm\)0.57 hours and in Group 3, it was 5.51\(\pm\)0.50 hours (p value<.05). In Group 1, mean total analgesic consumed in first 24 hours was 666.09\(\pm\)174.69 mg, in Group 2, it was 200.09\(\pm\)66.42 mg and in Group 3, it was 384.55\(\pm\)135.04 mg (p value<.05).
Conclusion: Dexamethasone as an adjunct to caudal Bupivacaine 0.25% (1ml/kg) provides effective postoperative analgesia.
