title: Evaluation of caudal dexamethasone with ropivacaine for post-operative analgesia in paediatric herniotomies: A randomised controlled study.
abstract: OBJECTIVE
  Caudal analgesia is one of the most popular regional blocks in paediatric patients undergoing infra-umbilical surgeries but with the drawback of short duration of action after single shot local anaesthetic injection. We evaluated whether caudal dexamethasone 0.1 mg/kg as an adjuvant to the ropivacaine improved analgesic efficacy after paediatric herniotomies.
  
  
  METHODS
  Totally 128 patients of 1-5 years age group, American Society of Anaesthesiologists physical status I and II undergoing elective inguinal herniotomy were randomly allocated to two groups in double-blind manner. Group A received 1 ml/kg of 0.2% ropivacaine caudally and Group B received 1 ml/kg of 0.2% ropivacaine, in which 0.1 mg/kg dexamethasone was added for caudal analgesia. Post operative pain by 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 Student's t-test. Pain scores measured at 1, 2, 4, and 6 h post-operative, were lower in Group B as compared to Group A. Mean duration of analgesia in Group A was 248.4 ± 54.1 min and in Group B was 478.046 ± 104.57 min with P = 0.001. Rescue analgesic requirement was more in Group A as compared to Group B. Adverse effects after surgery were comparable between the two groups.
  
  
  CONCLUSIONS
  Caudal dexamethasone added to ropivacaine is a good alternative to prolong post-operative analgesia with less pain score compared to caudal ropivacaine alone.
authors.affiliation: Department of Anaesthesia and Critical Care, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Santosh
authors.initials: S
authors.lastname: Choudhary
authors.affiliation: Department of Anaesthesia and Critical Care, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Neelam
authors.initials: N
authors.lastname: Dogra
authors.affiliation: Medicine Consultant in Private Hospital, Jaipur, Rajasthan, India.
authors.forename: Jaideep
authors.initials: J
authors.lastname: Dogra
authors.affiliation: Department of Anaesthesia and Critical Care, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Jain
authors.affiliation: Medical Officer, PHC Tyonda, Jhunjhunu, Rajasthan, India.
authors.forename: Sandeep Kumar
authors.initials: SK
authors.lastname: Ola
authors.affiliation: Department of Anaesthesia and Critical Care, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Brajesh
authors.initials: B
authors.lastname: Ratre
keywords: Caudal block; dexamethasone; paediatric herniotomy; ropivacaine