Comparison of Ropivacaine Alone Versus Ropivacaine With Dexamethasone in Caudal Block for Paediatric Postoperative Analgesia

Abstract

Background: Caudal block is a well-known technique for post operative analgesia for infraumbilical surgeries in paediatric patients. Ropivacaine is a long-acting local anaesthetic which is considered safe in paediatric population because of its property to produce differential neural blockade with less motor block along with reduced cardiovascular and neurological toxicity. Dexamethasone is successfully used as an adjunct in caudal blocks for children to reduce pain without inducing any signicant respiratory and hemodynamic effects. This study was done to compare the analgesic efcacy of ropivacaine with ropivacaine-dexamethasone combination in caudal block in paediatric patients. Materials And Methods: This prospective single blind randomized control study included 60 patients of ages 1 to 7 years, who were randomly allocated into two groups, Group R (n=30) who received 0.2% Ropivacaine 1ml/kg, and Group RD (n=30) who received 0.2% ropivacaine with dexamethasone 0.1mg/kg in caudal block. Patients were observed in the peri-operative period, and sedation scores, hemodynamic parameters, duration of analgesia, requirement of rescue analgesics and complications were recorded. Results: Ropivacaine-dexamethasone group was found to have longer duration of analgesia ( Group RD 720-870min ,Group R 360-480min), lesser requirement of rescue analgesic ( Group RD 1.03±0.26, Group R 1.43±0.5), lesser incidence of tachycardia, and fewer complications. Conclusion: Ropivacaine-dexamethasone combination was found to provide better post operative analgesia than ropivacaine alone in paediatric patients.