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Analgesic efficacy of caudal dexamethasone combined with ropivacaine in children undergoing orchiopexy

Authors
 E. M. Kim  ;  J. R. Lee  ;  B. N. Koo  ;  Y. J. Im  ;  H. J. Oh  ;  J. H. Lee 
Citation
 BRITISH JOURNAL OF ANAESTHESIA, Vol.112(5) : 885-891, 2014 
Journal Title
 BRITISH JOURNAL OF ANAESTHESIA 
ISSN
 0007-0912 
Issue Date
2014
MeSH
Amides* ; Anesthesia, Caudal/methods* ; Anesthetics, Combined* ; Anesthetics, Local* ; Anti-Inflammatory Agents* ; Child, Preschool ; Dexamethasone* ; Double-Blind Method ; Humans ; Infant ; Male ; Orchiopexy/methods* ; Pain Measurement/methods ; Pain, Postoperative/drug therapy ; Prospective Studies ; Treatment Outcome
Keywords
anaesthetic techniques ; regional ; caudal ; analgesia ; postoperative ; hormones ; corticosteroid ; paediatrics ; surgery ; day-case
Abstract
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.
Full Text
http://bja.oxfordjournals.org/content/112/5/885.long
DOI
10.1093/bja/aet484
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
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kim, Eun Mi(김은미)
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0001-6679-2782
Lee, Jeong Rim(이정림) ORCID logo https://orcid.org/0000-0002-7425-0462
Im, Young Jae(임영재)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99317
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