Comparison of duration of Postoperative Analgesia after Caudal Block with or without Intravenous Dexamethasone in Paediatric Day Care Infraumbilical Surgeries under General Anaesthesia

Nidhi Sharma; Nisha Kachru; Sandeep Kumar; Rupesh Yadav

doi:10.18502/aacc.v9i1.11941

Nidhi Sharma Department of Anaesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India.
Nisha Kachru Department of Anaesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India.
Sandeep Kumar Department of Anaesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India.
Rupesh Yadav Department of Anaesthesiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr RML Hospital, New Delhi, India.

DOI: https://doi.org/10.18502/aacc.v9i1.11941

Keywords: Analgesia; Dexamethasone; Pain; Bupivacaine

Abstract

Background: Pain is defined as a subject’s conscious perception of modulated nociceptive impulses that generate an unpleasant experience associated with actual or potential tissue damage. General anaesthesia, when combined with regional anaesthesia provides effective perioperative analgesia. Aim of the study was to study the effect of intravenous dexamethasone on duration of post-operative analgesia when given along with intra operative caudal block in paediatric day care infra umbilical surgeries under general anesthesia.

Methods: Sixty paediatric patients, American Society of Anesthesiologist’s class I and II, patients were randomly divided in to two groups. In Group D - 30 paediatric patients who were given intravenous dexamethasone in a dose of 0.2 mg/kg iv in 5 ml normal saline along with caudal block with 0.75ml/kg of 0.25% bupivacaine. Group S - 30 paediatric patients who were given 5 ml of normal saline intravenously along with caudal block with 0.75ml/kg of 0.25% bupivacaine. Primary objective of the study was to determine the duration of post-operative analgesia.

Results: The demographic data were comparable in both groups. There were no significant difference of mean (SD) Heart Rate and Mean arterial pressure (mmHg) at baseline, post-operative 1st hour, post-operative 2nd hour, post-operative 3rd hour, post-operative 4th hour (p value >0.05). Time for rescue analgesia (minutes) to be given was more in group D when compared to group S (190.67 ± 41.76 versus 181.17± 37.97) however it was not statistically significant. Total duration of analgesia(minutes), i.e., including both intra-operative and post-operative period was more in group D when compared to group S (266.83 ± 37.69 versus 255.73 ± 42.83). However, there was no significant difference between them. (p value=0.188).

Conclusion: We conclude that a single bolus dose of intravenous dexamethasone (0.2 mg/kg) given along with caudal block with 0.75 ml/kg of 0.25% bupivacaine did not prolong the duration of postoperative analgesia in paediatric patients.