• Sayed Kaoud Abd-Elshafy, Amany Makram Yacoup, Esam Eldein Mohamed Abdalla, Tarek Taha Hanafy El-Melegy, and Kelani Ali Abd-Elsalam.
• Department of Anesthesia, Intensive Care, and Pain Management, South Egypt Cancer Institute, Assiut University, Assiut, Egyp.
• Pain Physician. 2016 Jul 1; 19 (6): E841-52.

BackgroundControlling postoperative pain and vomiting in children remains a great challenge.ObjectiveStudy the efficacy of adding dexamethasone to caudal bupivacaine on postoperative analgesia and vomiting.Study DesignProspective, randomized double blind controlled clinical trial.SettingAssiut University Hospital.PatientsNinety children ASA I-II, undergoing lower orthopedic surgeries.MethodsPatients were randomly allocated into 3 equal groups. All received caudal block after induction of anesthesia with 0.5 mL/kg of 0.25% bupivacaine in addition to 5 mL intravenous (IV) normal saline in the control group, IV 0.5 mg/kg dexamethasone in IV dexamethasone group and lastly 0.1 mg/kg dexamethasone in the caudal dexamethasone group. Postoperative pain scores and rescue analgesic consumption were recorded. Blood glucose, postoperative vomiting, and other side effects were evaluated up to 24 hours after extubation.ResultsThe time of first analgesia and the number of patients requiring rescue analgesics were significantly decreased with intravenous or caudal dexamethasone. No significant increase in postoperative blood glucose levels were observed. A significant increase in B- Endorphin level at 3 and 24 hours postoperative was found in both dexamethasone groups when compared with the preoperative baseline value. The incidence of postoperative vomiting was significantly decreased in both dexamethasone groups in comparison with the control group. No other side effects were detected.LimitationsMeasurement of serum cortisol.ConclusionAnalgesic and antiemetic effects of dexamethasone as an adjunct to caudal block with bupivacaine (0.25%) 0.5 mL/kg is similar whether administered intravenously 0.5 mg/kg or caudally 0.1 mg/kg.

20 keywords...

hide…