Analgesic efficacy of caudal dexamethasone combined with ropivacaine in children undergoing orchiopexy.
BACKGROUND
Epidural administration of dexamethasone might reduce postoperative pain in adults. We evaluated whether a caudal block of 0.1 mg kg(-1) dexamethasone combined with ropivacaine improves analgesic efficacy in children undergoing day-case orchiopexy.


METHODS
This randomized, double-blind study included 80 children aged 6 months to 5 yr who underwent day-case, unilateral orchiopexy. Patients received either 1.5 ml kg(-1) of 0.15% ropivacaine (Group C) or 1.5 ml kg(-1) of 0.15% ropivacaine in which dexamethasone of 0.1 mg kg(-1) was mixed (Group D) for caudal analgesia. Postoperative pain scores, rescue analgesic consumption, and side-effects were evaluated 48 h after operation.


RESULTS
Postoperative pain scores at 6 and 24 h post-surgery were significantly lower in Group D than in Group C. Furthermore, the number of subjects who remained pain free up to 48 h after operation was significantly greater in Group D [19 of 38 (50%)] than in Group C [four of 37 (10.8%); P<0.001]. The number of subjects who received oral analgesic was significantly lower in Group D [11 of 38 (28.9%)] than in Group C [20 of 37 (54.1%); P=0.027]. Time to first oral analgesic administration after surgery was also significantly longer in Group D than in Group C (P=0.014). Adverse events after surgery including vomiting, fever, wound infection, and wound dehiscence were comparable between the two groups.


CONCLUSIONS
The addition of dexamethasone 0.1 mg kg(-1) to ropivacaine for caudal block can significantly improve analgesic efficacy in children undergoing orchiopexy. Clinical trial registration NCT01604915.
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, 120-752 Seoul, Republic of Korea.
E M
EM
Kim
J R
JR
Lee
B N
BN
Koo
Y J
YJ
Im
H J
HJ
Oh
J H
JH
Lee
D000577:Amides; D000763:Anesthesia, Caudal / Q000379:methods*; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D002675:Child, Preschool; D003907:Dexamethasone; D004311:Double-Blind Method; D006801:Humans; D007223:Infant; D008297:Male; D056126:Orchiopexy / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy; D011446:Prospective Studies; D000077212:Ropivacaine; D016896:Treatment Outcome
D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D000077212:Ropivacaine; D003907:Dexamethasone
anaesthetic techniques, regional, caudal; analgesia, postoperative; hormones, corticosteroid; paediatrics; surgery, day-case