Intravenous dexamethasone in combination with caudal block prolongs postoperative analgesia in pediatric daycare surgery

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Abstract

Background: This study was conducted to determine if intravenous dexamethasone combined with caudal block was able to prolong post-operative analgesia in pediatric daycare surgeries. Methods: Sixty four ASA I or II children aged 3 to 10 year old scheduled for daycare open unilateral herniotomy received general anesthesia and caudal block using 0.25% levobupivacaine 0.75 mg.kg<sup>-1</sup> with suppository paracetamol 30 mg.kg<sup>-1</sup>. After anesthesia induction, they were randomized to receive either intravenous dexamethasone 0.5 mg.kg<sup>-1</sup> (Group I) or same volume intravenous normal saline (Group II). Postoperatively, pain scores were assessed using WongBaker faces scale. At home, their parents assessed and recorded the pain scores, time to first oral paracetamol served and frequency of paracetamol given in two consecutive days post surgery. On the third postoperative day, these information were gathered from the parents via a phone call. Results: There were statistically significant differences between Group I and Group II in the median time to first paracetamol (800 vs 520 min, p = 0.01), mean pain scores postoperative day 1 (1.9 ± 2.0 vs 3.5 ± 2.2, p = 0.05), mean pain score postoperative day 2 (0.8 ± 1.6 vs 2.3 ± 2.0, p = 0.03) and mean frequencies of paracetamol given on postoperative day 2 (0.3 ± 0.8 vs 1.1 ± 1.0, p = 0.02). Conclusion: A single intravenous dexamethasone dose when combined with caudal block reduces postoperative pain, decreases paracetamol requirement and prolongs analgesic duration in children after open herniotomy.

Original languageEnglish
Pages (from-to)177-183
Number of pages7
JournalMiddle East Journal of Anesthesiology
Volume23
Issue number2
Publication statusPublished - 1 Jun 2015

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Acetaminophen
Analgesia
Dexamethasone
Pediatrics
Postoperative Pain
Parents
Pain
Suppositories
Ambulatory Surgical Procedures
General Anesthesia
Analgesics
Anesthesia

Keywords

  • Analgesia
  • Daycare
  • Dexamethasone
  • Pediatric
  • Postoperative

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

@article{137b4f9ebb5546eaa9a3e09dfce6aa2d,
title = "Intravenous dexamethasone in combination with caudal block prolongs postoperative analgesia in pediatric daycare surgery",
abstract = "Background: This study was conducted to determine if intravenous dexamethasone combined with caudal block was able to prolong post-operative analgesia in pediatric daycare surgeries. Methods: Sixty four ASA I or II children aged 3 to 10 year old scheduled for daycare open unilateral herniotomy received general anesthesia and caudal block using 0.25{\%} levobupivacaine 0.75 mg.kg-1 with suppository paracetamol 30 mg.kg-1. After anesthesia induction, they were randomized to receive either intravenous dexamethasone 0.5 mg.kg-1 (Group I) or same volume intravenous normal saline (Group II). Postoperatively, pain scores were assessed using WongBaker faces scale. At home, their parents assessed and recorded the pain scores, time to first oral paracetamol served and frequency of paracetamol given in two consecutive days post surgery. On the third postoperative day, these information were gathered from the parents via a phone call. Results: There were statistically significant differences between Group I and Group II in the median time to first paracetamol (800 vs 520 min, p = 0.01), mean pain scores postoperative day 1 (1.9 ± 2.0 vs 3.5 ± 2.2, p = 0.05), mean pain score postoperative day 2 (0.8 ± 1.6 vs 2.3 ± 2.0, p = 0.03) and mean frequencies of paracetamol given on postoperative day 2 (0.3 ± 0.8 vs 1.1 ± 1.0, p = 0.02). Conclusion: A single intravenous dexamethasone dose when combined with caudal block reduces postoperative pain, decreases paracetamol requirement and prolongs analgesic duration in children after open herniotomy.",
keywords = "Analgesia, Daycare, Dexamethasone, Pediatric, Postoperative",
author = "Arbi, {Murni Sari Ahmad} and Azarinah Izaham and Esa Kamaruzaman and Khairulamir Zainuddin and Hamidah Ismail and {Abdul Manap}, Norsidah",
year = "2015",
month = "6",
day = "1",
language = "English",
volume = "23",
pages = "177--183",
journal = "Middle East Journal of Anesthesiology",
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T1 - Intravenous dexamethasone in combination with caudal block prolongs postoperative analgesia in pediatric daycare surgery

AU - Arbi, Murni Sari Ahmad

AU - Izaham, Azarinah

AU - Kamaruzaman, Esa

AU - Zainuddin, Khairulamir

AU - Ismail, Hamidah

AU - Abdul Manap, Norsidah

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background: This study was conducted to determine if intravenous dexamethasone combined with caudal block was able to prolong post-operative analgesia in pediatric daycare surgeries. Methods: Sixty four ASA I or II children aged 3 to 10 year old scheduled for daycare open unilateral herniotomy received general anesthesia and caudal block using 0.25% levobupivacaine 0.75 mg.kg-1 with suppository paracetamol 30 mg.kg-1. After anesthesia induction, they were randomized to receive either intravenous dexamethasone 0.5 mg.kg-1 (Group I) or same volume intravenous normal saline (Group II). Postoperatively, pain scores were assessed using WongBaker faces scale. At home, their parents assessed and recorded the pain scores, time to first oral paracetamol served and frequency of paracetamol given in two consecutive days post surgery. On the third postoperative day, these information were gathered from the parents via a phone call. Results: There were statistically significant differences between Group I and Group II in the median time to first paracetamol (800 vs 520 min, p = 0.01), mean pain scores postoperative day 1 (1.9 ± 2.0 vs 3.5 ± 2.2, p = 0.05), mean pain score postoperative day 2 (0.8 ± 1.6 vs 2.3 ± 2.0, p = 0.03) and mean frequencies of paracetamol given on postoperative day 2 (0.3 ± 0.8 vs 1.1 ± 1.0, p = 0.02). Conclusion: A single intravenous dexamethasone dose when combined with caudal block reduces postoperative pain, decreases paracetamol requirement and prolongs analgesic duration in children after open herniotomy.

AB - Background: This study was conducted to determine if intravenous dexamethasone combined with caudal block was able to prolong post-operative analgesia in pediatric daycare surgeries. Methods: Sixty four ASA I or II children aged 3 to 10 year old scheduled for daycare open unilateral herniotomy received general anesthesia and caudal block using 0.25% levobupivacaine 0.75 mg.kg-1 with suppository paracetamol 30 mg.kg-1. After anesthesia induction, they were randomized to receive either intravenous dexamethasone 0.5 mg.kg-1 (Group I) or same volume intravenous normal saline (Group II). Postoperatively, pain scores were assessed using WongBaker faces scale. At home, their parents assessed and recorded the pain scores, time to first oral paracetamol served and frequency of paracetamol given in two consecutive days post surgery. On the third postoperative day, these information were gathered from the parents via a phone call. Results: There were statistically significant differences between Group I and Group II in the median time to first paracetamol (800 vs 520 min, p = 0.01), mean pain scores postoperative day 1 (1.9 ± 2.0 vs 3.5 ± 2.2, p = 0.05), mean pain score postoperative day 2 (0.8 ± 1.6 vs 2.3 ± 2.0, p = 0.03) and mean frequencies of paracetamol given on postoperative day 2 (0.3 ± 0.8 vs 1.1 ± 1.0, p = 0.02). Conclusion: A single intravenous dexamethasone dose when combined with caudal block reduces postoperative pain, decreases paracetamol requirement and prolongs analgesic duration in children after open herniotomy.

KW - Analgesia

KW - Daycare

KW - Dexamethasone

KW - Pediatric

KW - Postoperative

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M3 - Article

VL - 23

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EP - 183

JO - Middle East Journal of Anesthesiology

JF - Middle East Journal of Anesthesiology

SN - 0544-0440

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