EVALUATION OF ANALGESIC EFFICACY OF DEXAMETHASONE AS AN ADJUVANT TO CAUDAL BUPIVACAINE IN PAEDIATRIC PATIENTS UNDERGOING INFRAUMBLICAL SURGERY

Abstract

Background: caudal epidural block is one of the common regional techniques in paediatric anaesthesia for patients scheduled for infraumblical surgeries. Major disadvantage of this technique is its limited duration of action. Various adjuvants have been added to local anaesthetic agents for prolongation of analgesic effect of caudal block. The purpose of this study was to evaluate the analgesic efcacy of dexamethasone as an adjuvant to caudal bupivacaine in paediatric patients undergoing infraumblical surgeries. Material and method: 100 paediatric patients aged 1 to 6 years (< 20kg weight) of ASA class 1 or 2 scheduled for infraumblical surgery were enrolled in the study and randomly allocated in to two groups. Group B (n=50) received caudal block with 1ml/kg of 0.25% bupivacaine while Group D (n=50) received caudal block with 1ml/kg of 0.25% bupivacaine with 0.1 mg/kg dexamethasome. After completion of surgery, postoperative pain was assessed with FLACC (face, legs, activity, cry, consolability) scale at hourly interval till the score >3 (duration of analgesia). Both the groups were compared for the duration of analgesia and total analgesic requirement in the rst 24 hours postoperatively. Result: Group D showed signicantly longer duration of analgesia in comparison to Group B. Total analgesic requirement and mean FLACC score was also lower in Group D as compared to group B. Conclusion: Addition of dexamethasone (0.1mg/kg) to caudal bupivacaine increases the duration of postoperative analgesia and decreases the analgesic requirement during postoperative period