Comparison of Analgesic Efficacy of Caudal Dexamethasone with Intravenous Dexamethasone as an Adjuvant to Caudal Block in Pediatric Patients Undergoing Urogenital Surgeries

CONTEXT: Caudal block is one of the most common regional anesthetic techniques employed in pediatric urogenital surgeries. Adjuvants play an important role to improve postoperative analgesia. AIMS: The aim of this study was to evaluate the analgesic effect of dexamethasone when given systemically as against caudally as an adjuvant to caudal block. SUBJECTS AND METHODS: In this randomized controlled study, sixty American Society of Anesthesiologists Physical Status I and II patients aged 3–6 years were randomly allocated into two groups of thirty each. Group D received caudal block with local anesthetic solution and 0.1 mg/kg injection dexamethasone. Group I received a caudal block with local anesthetic solution. They received intravenous injection dexamethasone 0.1 mg/kg after the block. Both the groups were compared for the duration of postoperative analgesia and analgesic requirement. STATISTICAL ANALYSIS USED: Statistical analysis was done with unpaired t-test and Chi-square test as was appropriate. RESULTS: Group D showed a significant prolongation of postoperative analgesia (626.33 ± 59.39 min) as compared to Group I (194.67 ± 27.76 min). Similarly, requirement of analgesic was reduced on 1(st) postoperative day in group receiving caudal dexamethasone. CONCLUSIONS: Dexamethasone significantly prolongs the duration of postoperative analgesia of a caudal block when given caudally than when given intravenously.