Comparison of Caudal block with bupivacaine alone Versus Caudal block with Bupivacaine and intravenous Dexamethasone for Postoperative Analgesia of pediatrics Patient undergoing infra Umbilical surgery under general anesthesia at Tikur Anbessa Specialized Hospital, Addis Abeba ,Ethiopia,2019.

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Addis Abeba University


Background Caudal block is a common regional technique used to provide intra and postoperative analgesia of infra-umbilical procedures in pediatric patients. However, the relatively short duration of single shot caudal injection with local anesthetic is amongst the limitations of the procedure. Addition of various adjuvants has been challenged by unacceptable adverse effects & safety not being fully established, especially in preservative containing agents. Objective The aim of this study was to compare effectiveness of caudal block with bupivacaine alone versus caudal block with bupivacaine and IV dexamethasone for postoperative analgesia of pediatrics patient undergoing infra-umbilical surgery under General anesthesia at Tikur Anbessa specialized Hospital. Method: In this institutional based prospective cohort study total of 60 ASA I and ASA II age of 1-7 years pediatrics patient undergo infra-umbilical surgery that fulfill inclusion criteria was included. Systematic random sampling technique was applied & they grouped based on their exposure status. Severity of postoperative pain was measured by FLACC score, duration of analgesia and total analgesic consumption was assessed up to 24 hours after operation. Postoperative pain severity & total analgesic consumption was analyzed by Mann-Whitney U test. Independent sample t test was used for analgesia duration as well as Chi-square test was used to analyze categorical variables and p value less than 0.05 was considered as statistically significant. Result data of 60 patients were analyzed and the result shows postoperative pain severity presented in median in CB with bupivacaine & IV dexamethasone group was 1.5, 3,6 & 3, 6, 6 in CB with bupivacaine alone group at 4 th , 6 th & 12 th hours with p value of (<0.001, <0.001& 0.003) respectively. Duration of analgesia was also significantly prolonged in CB with IV dexamethasone group with mean of 699.3 minutes & 347 minutes in CB alone group with p < 0.001. Amount of analgesia given in 24 hours was also significantly reduced in CB with IV dexamethasone group with p <0.001. Conclusion and recommendation administration of 0.5mg/kg of intravenous dexamethasone in combination with caudal block is good alternative to prolong postoperative analgesia in children undergoing infra-umbilical surgery.



Caudal block, infra-umbilical surgery, IV dexamethasone, pediatrics, postoperative analgesia