Trends in Clinical and Medical Sciences
Special issue: Indian Medical Research Views and Findings on Last 5 years (2023), pp. 111 – 118
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-imrv017
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-imrv017
Comparison of analgesic efficacy of caudal and intravenous dexamethasone as an adjuvant to caudal block: A randomized, double-blind study
Yogesh Dodiyar\(^{1}\), Neetu Gupta\(^{1}\), KK Arora\(^{1}\), Aseem Sharma\(^{1,*}\), Bharti Anjane\(^{1}\) and Rishi Dhurve\(^{2}\)
\(^{1}\) Department of Anaesthesia, Mahatma Gandhi Medical College.
\(^{2}\) Department of Microbiology, Mahatma Gandhi Medical College.
Correspondence should be addressed to Aseem Sharma at aseem.sharama12@hotmail.com
Copyright © 2023 Yogesh Dodiyar, Neetu Gupta, KK Arora, Aseem Sharma, Bharti Anjane and Rishi Dhurve. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: March 25, 2023 – Accepted: May 8, 2023 – Published: May 14, 2023
Abstract
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.
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.
Keywords:
dexamethasone; Caudal block; Analgesia; Children; Post-operative pain.