Abstract:

Background and Aims: Caudal analgesia is one of the most popular regional blocks in pediatric patients undergoing infra-umbilical surgeries but with the drawback of short duration of action after single shot local anaesthetic injection, we evaluated the efficacy of dexamethasone 0.1mg/kg when combined with 0.15% ropivacaine for caudal analgesia.

Methods: Totally 60 patients of 1–5 years age group, American Society of Anesthesiologists physical status I and II undergoing elective infra umbilical surgeries were randomly allocated to two groups in double-blind manner. Group R received 1 ml/kg of 0.15% ropivacaine caudally and Group D received 1 ml/kg of 0.15% ropivacaine, in which 0.1 mg/kg dexamethasone was added for caudal analgesia. Post-operative pain by faces,  legs, activity, cry and CONSOL ability, tool score, rescue analgesic requirement and adverse effects were noted for 24h. Results: Results were statistically analyzed using Student’s t-test. Pain scores measured at 1, 2, 4, and 6 h (for 24hrs) post-operative, were lower in Group D as compared to Group R. Mean duration of analgesia in Group R was 234.17 ± 61.37 min and in Group D was 447.13 ± 96.26 min with P < 0.0001. Rescue analgesic requirement was more in Group R as compared to Group D (p=0.001). Adverse effects after surgery were comparable between the two groups.

Conclusion: Caudal dexamethasone added to ropivacaine is a good alternative to prolong post-operative analgesia with less pain score compared to caudal ropivacaine alone.

Key words: Caudal block, dexamethasone, infra-umbilical surgeries, ropivacaine.