Comparison of Dexamethasone Added to Ropivacaine and Ropivacaine Alone in Caudal Analgesia in Children Undergoing Orchiopexy
Condition: Cryptorchidism
MeSH terms: Cryptorchidism
Study type: Interventional

Summary: 
      Single shot caudal epidural block is one of the most widespread technique for pediatric pain
      management after infraumbilical surgical procedures.

      However, in a significant proportion of patients, despite good initial analgesia from a
      caudal block with local anesthetic, pain develops after the block resolves.

      In order to decrease postoperative analgesic requirements after caudal block, various drugs
      such as opioids, ketamine, clonidine, or dexmedetomidine to local anesthetics has been
      investigated. However, their use has been limited by adverse effects in children.

      Recently, many study suggested that epidurally administered dexamethasone could reduce the
      incidence and severity of postoperative pain in adults. But there is no study concerning the
      use of dexamethasone, as an adjuvant agent for the caudal epidural block in children.

      The investigators performed prospective randomized double-blind study to examine the
      analgesic effect of dexamethasone added to ropivacaine and ropivacaine alone in caudal
      analgesia on postoperative pain control in pediatric patients undergoing orchiopexy.

      80 children (aged 0.5-5 yr) undergoing day-case orchiopexy were included in this prospective,
      randomized, double-blinded study. After inhalation induction of general anesthesia, caudal
      block was applied. Patients were randomly assigned in two groups. Normal saline 0.02mL/Kg
      added to ropivacaine 0.15% 1.5ml/kg was administered to Group R , dexamethasone 0.1mg/kg
      added to ropivacaine 0.15% 1.5ml/kg to Group DR. Postoperative pain was recorded at 30min and
      1,2,3 h by using Hospital of Eastern Ontario Pain Scale (CHEOPS, 0-10) and Faces Legs
      Activity Cry Consolability tool (FLACC, 0-10). Participants will be followed for the duration
      of hospital stay, an expected average of 3 hours.

      After discharge, rescue analgesic consumption, pain scores, and adverse effects were
      evaluated for 24h.

      The time to first supplemental oral analgesic medication demand was defined as the time from
      the end of surgery to the first registration of a VAS ( 0-10) ≥ 5 by parent's observation.
      Twenty-four hours after surgery, reports of delayed side effects and demands for rescue
      analgesics from the child were gathered from parents via a telephone interview.
    


Intervention name(s): Caudal block; Caudal block
Intervention type(s): Procedure; Procedure
Intervention description(s): After inhalation induction of general anesthesia, caudal block was applied. Patients were randomly assigned in two groups. Normal saline 0.02mL/Kg added to ropivacaine 0.15% 1.5ml/kg was administered to Group R.; After inhalation induction of general anesthesia, caudal block was applied. Patients were randomly assigned in two groups. Dexamethasone 0.1mg/kg added to ropivacaine 0.15% 1.5ml/kg to Group DR.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment