The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled study : Dexamethasone for pain management in children.

Autor: Khalifa SB; Department of Anesthesia and Intensive Care, Robert Ballanger Hospital, 1 boulevard Robert Ballanger, Aulnay-Sous-Bois, 93602, France., Slimene AB; Department of Anesthesia and Intensive Care, Children Hospital, Boulevard 9 avril, Baab Saadoun, Tunis, Tunisia., Blaiti H; Department of Anesthesia and Intensive Care, Children Hospital, Boulevard 9 avril, Baab Saadoun, Tunis, Tunisia., Kaddour R; Department of Anesthesia and Intensive Care, Robert Ballanger Hospital, 1 boulevard Robert Ballanger, Aulnay-Sous-Bois, 93602, France., Hassen AF; Department of Anesthesia and Intensive Care, Children Hospital, Boulevard 9 avril, Baab Saadoun, Tunis, Tunisia., Pardessus P; Université de Paris-Cité, Paris, France.; Department of Anesthesia and Intensive Care, Robert Debré Hospital, 48 boulevard Sérurier, Paris, 75019, France.; FHU I2D2. Robert Debré Hospital, 48 boulevard Sérurier, Paris, 75019, France., Brasher C; Department of Anesthesia & Pain Management, Royal Children's Hospital, Melbourne, Australia.; Anesthesia and Pain Management Research Group, Murdoch Children's Research Institute, Parkville, Australia.; Department for Integrated Critical Care, University of Melbourne, Melbourne, Australia., Dahmani S; Department of Anesthesia and Intensive Care, Robert Ballanger Hospital, 1 boulevard Robert Ballanger, Aulnay-Sous-Bois, 93602, France. souhayl.dahmani@aphp.fr.; Université de Paris-Cité, Paris, France. souhayl.dahmani@aphp.fr.; Department of Anesthesia and Intensive Care, Robert Debré Hospital, 48 boulevard Sérurier, Paris, 75019, France. souhayl.dahmani@aphp.fr.; FHU I2D2. Robert Debré Hospital, 48 boulevard Sérurier, Paris, 75019, France. souhayl.dahmani@aphp.fr.
Jazyk: angličtina
Zdroj: BMC anesthesiology [BMC Anesthesiol] 2024 Apr 16; Vol. 24 (1), pp. 145. Date of Electronic Publication: 2024 Apr 16.
DOI: 10.1186/s12871-024-02536-3
Abstrakt: Introduction: Evidence regarding the potentiating effects of intravenous dexamethasone on peripheral regional anesthesia in children is sparse. The objective of the current study was to investigate the potentiating effect of intravenous dexamethasone upon pudendal block during surgical correction of hypospadias using Snodgrass technique.
Methods: The study consisted of a monocentric, randomized controlled, double-blinded study. Patients were randomized to receive either intravenous dexamethasone 0.15 mg.kg - 1 (D group) or a control solution (C group). Both groups received standardized anesthesia including a preemptive pudendal block performed after the induction of anesthesia. The primary outcome was the proportion of patients needing rescue analgesia. Secondary outcomes were other pain outcomes over the first 24 postoperative hours.
Results: Overall, 70 patients were included in the study. Age were 24 [24; 36] and 26 [24; 38] months in the D and C groups, respectively (p = 0.4). Durations of surgery were similar in both groups (60 [30; 60], p = 1). The proportion of patients requiring rescue analgesia was decreased in the D group (23% versus 49%, in D and C groups respectively, p = 0.02). The first administration of rescue analgesia was significantly delayed in the D group. Postoperative pain was improved in the D group between 6 and 24 h after surgery. Opioid requirements and the incidence of vomiting did not significantly differ between groups.
Conclusion: Associating intravenous dexamethasone (0.15 mg.kg - 1 ) to pudendal block during hypospadias surgery improves pain control over the first postoperative day. Further studies are needed in order to confirm these results.
Gov Identifier: NCT03902249. A.
What Is Already Known: dexamethasone has been found to potentiate analgesia obtained with regional anesthesia in children. B. WHAT THIS ARTICLE ADDS: intravenous dexamethasone was found to improve analgesia with a preemptive pudendal block during hypospadias surgery. C. IMPLICATIONS FOR TRANSLATION: results of this study indicate that intravenous dexamethasone could be used as an adjunct to pudendal block.
(© 2024. The Author(s).)
Databáze: MEDLINE
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