The efficacy of single dose intravenous dexamethasone vs placebo combined with caudal block on postoperative analgesia in children undergoing outpatient urologic surgery: A prospective, double-blind, randomized study.
- Author:
Sheila Bianca M. Santy
;
Marichu D. Battad
;
Janette F. Pascual
- Publication Type:Journal Article
- From:
The Philippine Children’s Medical Center Journal
2019;15(2):72-79
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND:Pain in the pediatric age is more difficult to assess and treat. Inadequate pain
management may produce anxiety and trauma in children and affect not only the surgical outcome but
the child‘s overall quality of life and recovery. Advances in various perioperative techniques to
provide optimal analgesia continually grow especially in the outpatient setting where there are a
significant number of pediatric patients. Caudal block is easy to perform and can be used in
combination with general anesthesia. It provides excellent analgesia but is often short-lived.
Dexamethasone is a potent synthetic glucocorticoid with anti-inflammatory and anti-emetic properties.
The exact mechanism for its analgesic action is said to be related to its strong anti-inflammatory
action.
OBJECTIVES:The study aims to determine and compare the anxiety of children with acute
lymphoblastic leukemia (ALL) and their well siblings based on Child drawing: Hospital manual and to
identify factors associated with the level of anxiety.
METHODOLOGY:This is a prospective, double-blind, randomized study that included sixty-four
patients, aged 3 - 12 years old, ASA I and II, scheduled for outpatient urologic surgery under
combined general and regional caudal anesthesia. Patients were randomized into two groups: Group D
received 0.5mg/kg (maximum of 16mg) single dose intravenous dexamethasone in 5mL volume and
Group P received the same volume of saline after the start of surgery when successful caudal block
was determined. Postoperative pain scores using the Wong-Baker Faces Pain Rating Scale and vital
signs were monitored at the PACU at hourly intervals until discharge. The time to first rescue
analgesic and the total analgesic consumption given at home for forty-eight hours were recorded.
RESULTS:Group D showed significantly longer block duration and time to rescue analgesic and
lesser analgesic consumption.
CONCLUSION:A single dose intravenous dexamethasone combined with caudal block effectively
prolongs duration of caudal block and time to first rescue analgesic and lessens analgesic consumption
in children undergoing outpatient urologic surgery.
- Full text:The efficacy of single dose intravenous dexamethasone.pdf
