Salami Omotayo Felicia, Amanor-Boadu Simbo Daisy, Eyelade Olayinka Ranti, Olateju Simeon Olugbade
Department of Anaesthesia and Intensive Care, Ben Carson School of Medicine, Babcock University, Ogun State, Nigeria.
Department of Anaesthesia and Intensive Care, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.
Niger Postgrad Med J. 2017 Oct-Dec;24(4):230-235. doi: 10.4103/npmj.npmj_120_17.
Caudal analgesia for postoperative pain relief in paediatric day-case surgery has been found to be of short duration, hence the need for addition of adjuncts to prolong the analgesia.
The objective of the study was to compare the analgesic effects of caudal block with or without low-dose intravenous dexamethasone in children undergoing day-case herniotomy.
This was a prospective randomised controlled study conducted in male patients, aged between 1 and 7 years scheduled for herniotomy. A total of 94 patients were randomised into two groups. Group A received intravenous 0.25 mg/kg dexamethasone in 5 ml solution, whereas Group B received equivalent volume of intravenous normal saline. All the patients had a caudal block. Post-operative pain was assessed and recorded in post-anaesthesia care unit (PACU) using objective pain scale. Time to first analgesia request (TFA), pain scores and complications were documented. Data were analysed using Statistical Package for the Social Sciences version 21.0.
A total of 94 patients were analysed with a mean age of 3.30 ± 1.67 and 3.06 ± 1.50 years for Groups A and B, respectively. The TFA request was 654.18 ± 31.56 and 261.50 ± 10.82 min in Groups A and B, respectively, P = 0.0001. Postoperatively, in the PACU, there was statistically significant difference in pain score between the two groups at 0, 30, 60, 120, 180 and 240 min (P = 0.0001) all through.
The use of low-dose intravenous dexamethasone (0.25 mg/kg) in combination with caudal block prolonged duration of analgesia, reduced pain scores and analgesic consumption postoperatively, in children undergoing day-case herniotomy.
已发现小儿日间手术中用于术后镇痛的骶管阻滞持续时间较短，因此需要添加辅助药物来延长镇痛时间。
本研究的目的是比较在接受日间疝修补术的儿童中，骶管阻滞联合或不联合小剂量静脉注射地塞米松的镇痛效果。
这是一项前瞻性随机对照研究，研究对象为计划接受疝修补术的1至7岁男性患者。总共94例患者被随机分为两组。A组接受静脉注射5毫升溶液中含0.25毫克/千克地塞米松，而B组接受等量的静脉注射生理盐水。所有患者均接受骶管阻滞。在麻醉后护理单元（PACU）使用客观疼痛量表对术后疼痛进行评估和记录。记录首次镇痛需求时间（TFA）、疼痛评分和并发症。使用社会科学统计软件包21.0对数据进行分析。
总共对94例患者进行了分析，A组和B组的平均年龄分别为3.30±1.67岁和3.06±1.50岁。A组和B组的TFA需求分别为654.18±31.56分钟和261.50±10.82分钟，P = 0.0001。术后，在PACU中，两组在0、30、六十、120、180和240分钟时的疼痛评分均存在统计学显著差异（P = 0.0001）。
在接受日间疝修补术的儿童中，使用小剂量静脉注射地塞米松（0.25毫克/千克）联合骶管阻滞可延长镇痛时间，降低术后疼痛评分并减少镇痛药物用量。
