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Effect of dexamethasone in combination with caudal analgesia on postoperative pain control in day-case paediatric orchiopexy.

Authors
 J.-Y. Hong  ;  S. W.Han  ;  W. O. Kim  ;  E. J. Kim  ;  H. K. Kil 
Citation
 BRITISH JOURNAL OF ANAESTHESIA, Vol.105(4) : 506-510, 2010 
Journal Title
 BRITISH JOURNAL OF ANAESTHESIA 
ISSN
 0007-0912 
Issue Date
2010
MeSH
Acetaminophen/administration & dosage ; Ambulatory Surgical Procedures ; Analgesics, Non-Narcotic/administration & dosage ; Analgesics, Opioid/administration & dosage ; Anesthesia, Caudal/methods* ; Anti-Inflammatory Agents/administration & dosage* ; Child, Preschool ; Dexamethasone/administration & dosage* ; Double-Blind Method ; Drug Administration Schedule ; Fentanyl/administration & dosage ; Glucocorticoids/administration & dosage ; Humans ; Infant ; Infusions, Intravenous ; Male ; Orchiopexy* ; Pain Measurement/methods ; Pain, Postoperative/prevention & control* ; Prospective Studies
Keywords
anaesthesia, caudal ; anaesthesia recovery period ; analgesia, postoperative ; dexamethasone ; surgery, day case ; surgery, urological, paediatric ; orchiopexy
Abstract
BACKGROUND: Dexamethasone has a powerful anti-inflammatory action and has demonstrated reduced morbidity after surgery. The aim of this study was to examine the effects of a single i.v. dose of dexamethasone in combination with caudal block on postoperative analgesia in children. METHODS: Seventy-seven children (aged 1-5 yr) undergoing day-case orchiopexy were included in this prospective, randomized, double-blinded study at a single university hospital. After inhalation induction of general anaesthesia, children received either dexamethasone 0.5 mg kg(-1) (maximum 10 mg) (n=39) or the same volume of saline (n=38) i.v. A caudal anaesthetic block was then performed using 1.5 ml kg(-1) of ropivacaine 0.15% in all patients. After surgery, rescue analgesic consumption, pain scores, and adverse effects were evaluated for 24 h. RESULTS: Significantly, fewer patients in the dexamethasone group required fentanyl for rescue analgesia (7.9% vs 38.5%) in the post-anaesthetic care unit or acetaminophen (23.7% vs 64.1%) after discharge compared with the control group. The time to first administration of oral acetaminophen was significantly longer in the dexamethasone group (646 vs 430 min). Postoperative pain scores were lower in the dexamethasone group and the incidence of adverse effects was similar in both groups. CONCLUSIONS: Intravenous dexamethasone 0.5 mg kg(-1) in combination with a caudal block augmented the intensity and duration of postoperative analgesia without adverse effects in children undergoing day-case paediatric orchiopexy. Trial registration: ClinicalTrials.gov. The number of registration: NCT01041378.
Files in This Item:
T201002695.pdf Download
DOI
10.1093/bja/aeq187
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kil, Hae Keum(길혜금)
Kim, Won Oak(김원옥)
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
Hong, Jeong Yeon(홍정연)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101663
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