Introduction: Epidural administration of dexamethasone might reduce postoperative pain in
adults. We evaluated whether a caudal block of 0.1 mg/kg dexamethasone combined with
ropivacaine improves analgesic efficacy in children undergoing day-case orchiopexy.
Methods: This randomized, double-blind study included 80 children aged 6 months to 5 yr
who underwent day-case, unilateral orchiopexy. Patients received either 1.5 ml/kg of 0.15%
ropivacaine (Group C) or 1.5 ml/kg of 0.15% ropivacaine in which dexamethasone of
0.1mg/kg was mixed (Group D) for caudal analgesia. Postoperative pain scores, rescue
analgesic consumption, and side-effects were evaluated 48 h after operation.
Results: Postoperative pain scores at 6 and 24 h post-surgery were significantly lower in
Group D than in Group C. Furthermore, the number of subjects who remained pain free up to
48 h after operation was significantly greater in Group D [19 of 38 (50%)] than in Group C
[4 of 37 (10.8%); P<0.001]. The number of subjects who received oral analgesic was
significantly lower in Group D [11 of 38 (28.9%)] than in Group C [20 of 37 (54.1%);
P=0.027]. Time to first oral analgesic administration after surgery was also significantly
longer in Group D than in Group C (P=0.014). Adverse events after surgery including
vomiting, fever, wound infection, and wound dehiscence were comparable between the two
groups.
Conclusion: The addition of dexamethasone 0.1 mg/kg to ropivacaine for caudal block can
significantly improve analgesic efficacy in children undergoing orchiopexy.
Keyword: Caudal anaesthesia, Children, Dexamethasone, Orchiopexy, Postoperative
analgesia
