Analgesic effectiveness of dexamethasone levobupivacaine combination for caudal analgesia in pediatric patients undergoing infraumbilical surgery: A randomized controlled double-blind study

摘要

Background: the aim of this study was to evaluate the postoperative analgesic role of dexamethasone as an adjuvant to levobupivacaine in a single shot caudal block in children undergoing lower abdominal or urological procedures. Methods: the study involved 50 children between 1 and 7 years of age scheduled for elective lower abdominal or urological procedures. the children were randomly allocated into one of two treatment groups according to injected solution of caudal block: group l or group dl. group l (n = 25) received levobupivacaine 0.8 ml/kg and group dl (n = 25) received levobupivacaine 0.8 ml/Kg mixed with dexamethasone 0.1 mg/kg. the primary outcome measure was the quality and duration of analgesia. secondary outcome measures included the degree of sedation, residual motor block and any side-effects. the postoperative pain was evaluated using a objective pain scale (ops). Results: up to two hours postoperatively, all children had no pain in both groups. from 3 hours up to 12 hours, OPS scores were significantly lower in Group DL. Duration of analgesia was significantly longer in Group DL (p = 0.009). Children in Group DL required significantly smaller doses of paracetamol during the 24 hours (p <0.001). Sedation score was 1 during the first 24 postoperative hours except in few children. few children developed nausea and vomiting or fever. Conclusion: Mixing dexamethasone 0.1 mg/kg with levobupivacaine provided significantly better and longer duration of postoperative analgesia after caudal block in pediatric patients.