Effect of dexamethasone in combination with caudal analgesia on postoperative pain control in day-case paediatric orchiopexy

Abstract

ClinicalTrials.gov. The number of registration: NCT01041378.

The role of dexamethasone in peripheral and neuraxial nerve blocks for the management of acute pain

“…4,8,9 Naghipour examined the use of perineural dexamethasone in thoracic and lumbar epidurals; 10 and Hong, Kim and Murni explored systemic dexamethasone in conjunction with caudal blocks in a paediatric group. 2,11,12 Choi's systematic review and meta-analysis examined its use in nine studies in conjunction with different forms of brachial plexus blocks via both systemic and perineural approaches. 4 These nine studies were examined on an individual basis for the purposes of this review.…”

“…It appears that dexamethasone is able to act synergistically with local anaesthetics to achieve a better quality and duration of analgesia, limiting the need for alternative analgesics -particularly opioids. [1][2][3][4] Controversy still exists regarding the route of administration of dexamethasone and dose ranges are wide and unstandardised. 1,2,5,6 The safety of this practice is also questioned: long-term glucocorticosteroid use is associated with significant adverse effects, yet the complications associated with a single perioperative dose are not fully appreciated.…”

“…[1][2][3][4] Controversy still exists regarding the route of administration of dexamethasone and dose ranges are wide and unstandardised. 1,2,5,6 The safety of this practice is also questioned: long-term glucocorticosteroid use is associated with significant adverse effects, yet the complications associated with a single perioperative dose are not fully appreciated. 1 We aimed to conduct a semi-structured review of the current literature to assess the role of dexamethasone as an analgesic adjunct with regional techniques.…”

Safety of perioperative dexamethasone administration in children: time for reflection?

“…La Society for Ambulatory Anesthesia a évalué de façon critique les données probantes concernant la prévention et la prise en charge adaptées des NVPO, et les directives qui se sont ensuivies recommandent l'utilisation de dexaméthasone en tant qu'antiémétique prophylactique efficace chez les enfants à la dose de 150 lgÁkg -1 , jusqu'à un maximum de 5 mg. 6 Les autres utilisations périopératoires de la dexaméthasone chez l'enfant se sont concentrées sur l'analgésie après des interventions telles que les amygdalectomies 7 et les orchidopexies. 8 Les divers avantages de la dexaméthasone sont si bien acceptés que ce médicament est aujourd'hui communément utilisé en période périopératoire, en général en dose unique modeste. Existe-t-il des données probantes suggérant que cette pratique comporte un risque significatif -particulièrement pour l'enfant?…”

“…The Society for Ambulatory Anesthesia has critically evaluated the evidence for appropriate prevention and management of PONV, and the ensuing guidelines recommend dexamethasone as an effective prophylactic antiemetic in children at a dose of 150 lgÁkg -1 , up to 5 mg. 6 Other perioperative effects of dexamethasone in children have focused on analgesia after procedures such as tonsillectomy 7 and orchidopexy. 8 The various benefits of dexamethasone are so well accepted that this drug is now used very widely in the perioperative period, usually as a single modest dose. Is there any evidence that this practice carries any significant riskparticularly in pediatric patients?…”