Abstract
To assess the effectiveness of intravenous dexamethasone along with caudal block in improving analgesia following inguinal hernia repair in children. The double-blind randomised controlled trial was conducted over a 6-month period from June 01, 2016 to November 30, 2016 at the Aga Khan University Hospital, Karachi, and comprised patients aged 1-5 years, scheduled for elective inguinal hernia repair. The subjects were randomised into two groups using the sealed envelope technique. Group D patients received 0.5mg/kg dexamethasone intravenous in 5ml, and group P was given placebo (5ml 0.9% saline). Assessment of postoperative pain was made through the faces, legs, activity, cry and consolability tool at 30 minutes and hourly for 4 hours. Rescue analgesia was given at pain score 3 or more with intravenous pethidine 0.5 mg/kg. SPSS 19 was used for data analysis. Of the 64 patients, there were 55(85.9%) boys and 9(14.1%) girls. The overall mean age was 29.8}13.8 months. The mean postoperative pain score was significantly higher in group P (p<0.05). At 30 minutes and two hours postoperatively, need for analgesia was also significantly higher in group P (p<0.05). In paediatric day-care inguinal hernia repair, dexamethasone could be used effectively for improving pain relief.
Highlights
Adequate analgesia with minimal side effects is an important requirement for surgeries performed on a daycase basis.[1]
Dexamethasone is a corticosteroid with potent anti-inflammatory effect which might contribute to postoperative analgesia
The current study was planned to determine the effectiveness of IV dexamethasone along with caudal analgesia in improving pain relief in children undergoing inguinal hernia repair
Summary
Adequate analgesia with minimal side effects is an important requirement for surgeries performed on a daycase basis.[1]. An intraoperative intravenous (IV) injection of 8mg dexamethasone has been shown to be effective in reducing postoperative analgesic requirements in dental and thyroid surgeries in adults.[7,8]. Children receiving IV dexamethasone with caudal block were found to need less rescue analgesia compared to the control group (7.9% vs 38.5%) following orchidopexy.[9] Another study showed similar results when caudal block with levobupivacaine was used with IV dexamethasone in children.[10] In another randomised controlled trial, single-dose dexamethasone in combination with penile block decreased postoperative analgesic requirement.[11] Caudal block with bupivacaine has duration of action of around 03 hours.[12,13] The current study was planned to determine the effectiveness of IV dexamethasone along with caudal analgesia in improving pain relief in children undergoing inguinal hernia repair
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