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- Title
Comparison of Analgesic Efficacy between Bupivacaine with Dexamethasone versus Bupivacaine in Caudal Block for Pediatric Patients Undergoing Lower Abdominal Surgeries.
- Authors
GadAlla, Raouf Ramzy; Hussien, Noha Sayed; Armanious, Simon Halim; Fawaz, Mariam Momtaz; Younan, Younan Sayed
- Abstract
Background: Caudal analgesia is one of the most popular regional blocks in paediatric patients undergoing lower abdominal surgeries but with the drawback of short duration of action after single shot local anaesthetic injection. We evaluated whether caudal dexamethasone as an adjuvant to the Bupivacaine improves analgesic efficacy after paediatric lower abdominal surgeries. Aim of the Study: The current study is conducted to evaluate the analgesic effect of dexamethasone when given caudally as an adjuvant to bupivacaine for children undergoing lower abdominal surgeries eg: open inguinal hernia repair, hypospidius, orchidopexy and circumcision surgeries. Methods: Totally 60 patients of 1-3 years age group, American Society of Anaesthesiologists physical status I and II undergoing elective lower abdominal surgeries were randomly allocated to two groups in double-blind manner. Group B (the control group) received 1 ml/kg of 0.25% bupivacaine caudally for lower abdominal surgeries and 0.5 ml/kg for anal and penile surgeries and Group BD received 1 ml/kg of 0.25% bupivacaine for lower abdominal surgeries and 0.5 ml/kg for anal and penile surgeries, in which 0.1mg/kg dexamethasone was added for caudal analgesia. Post operative pain by FLACC scale (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 KRUSKAL-WALLIS TEST. Pain scores measured at 4,8 and 12h post-operative, were lower in Group BD as compared to Group B Mean duration of analgesia in Group BD 1026±139,8min and in Group B was 465,6 ± 79,2 min with P = 0.001. Rescue analgesic requirement was more in Group B as compared to Group BD. Adverse effects after surgery were comparable between the two groups. Conclusion: Caudal dexamethasone added to bupivacaine is a good alternative to prolong post-operative analgesia with less pain score compared to caudal bupivacaine alone.
- Subjects
ABDOMINAL surgery; CHILD patients; BUPIVACAINE; HERNIA surgery; ORCHIOPEXY; ANAL surgery
- Publication
QJM: An International Journal of Medicine, 2024, Vol 117, pi3
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hcae070.007