Analgesic efficacy of caudal dexamethasone combined with ropivacaine in children undergoing orchiopexy

Abstract

The addition of dexamethasone 0.1 mg kg(-1) to ropivacaine for caudal block can significantly improve analgesic efficacy in children undergoing orchiopexy. Clinical trial registration NCT01604915.

The Effect of 1 µg/kg Dexmedetomidine Combined with High-Volume/Low-Concentration Caudal Ropivacaine in Children Undergoing Ambulatory Orchiopexy

“…19) As the sacral region has the largest concentration of α 2 -adrenoceptors than the lumbar or thoracic regions in humans, 20,21) caudally administered DEX combined with local anesthetics could provide effective analgesia. In this current study, although the analgesic duration was shorter than that in other studies that used a higher concentration (0.25%) of bupivacaine 4,[10][11][12][13] or ropivacaine, 17) the analgesic duration Pre-incision, value before surgical incision; Incision, value after surgical incision; 10 min, value 10 min after iincision; End, value at the end of surgery. * p<0.05. was significantly longer in DEX group than in control group.…”

“…Additionally, caudal DEX with a low-concentration of local anesthetics induces less adverse effects (motor weakness, delayed micturition of urinary retention) that may affect early discharge from hospital, compared with a higher concentration of local anesthetics. 3,4,10,12,13,23) DEX has anxiolytic, sedative, and hypnotic properties caused by stimulation of the α2-adrenoceptor in the locus coeruleus in brain where it decreases a neuronal activation 9,24) and can reduce the requirement of concomitantly administered hypnotics, analgesics, or anesthetics. 25) Intravenous DEX significantly decreases the sevoflurane requirement 5,26) for anesthesia and EA during recovery.…”

“…On the basis of previous studies, 4,9,11,12,17) we determined that 32 patients would be required in each group with an α level of 0.05 and power of 90% to detect a 10 h difference in time to the first analgesic request between the groups. Forty children were enrolled in each group to allow for a potential 20% drop-out.…”

“…Recently, high-volume/low-concentration (HVLC) regimens for caudal blocks in children (1.5 mL/kg of 0.1-0.2% local anesthetics) have gained popularity following a report by Silvani et al that demonstrated that a HVLC regimen provides a longer analgesic duration with less adverse effects than conventional dose/concentration. [3][4][5][6][7][8] However, the analgesic duration is still limited in caudal block with single-injection.Dexmedetomidine (DEX) is a highly selective α 2 adrenoceptor agonist with an α2/α1 selectivity ratio of 1600 : 1, and is eight times more potent than clonidine. 9) DEX is successfully used as an adjuvant in caudal blocks for children in order to reduce pain without inducing any significant respiratory and hemodynamic effects.…”

Caudal Anesthesia: Experience in the Post-Operative Analgesia in Pediatric Ambulatory Surgery at the University Hospital of Treichville

“…Caudal anesthesia finds its place in the per-and post-operative analgesia of almost all interventions involving the lower abdomen and lower limbs; especially in infants and young children [1] [2] [3] [4] [5]. It is safe and effective to receive a sufficient period of analgesia, regardless of the type of surgery [6] [7] [8] [9] [10].…”