The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled study
Abstract 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 corre...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-024-02536-3 |
| _version_ | 1797199252050411520 |
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| author | Sonia Ben Khalifa Ahmed Ben Slimene Hajer Blaiti Refka Kaddour Amjed Fekih Hassen Pierre Pardessus Christopher Brasher Souhayl Dahmani |
| author_facet | Sonia Ben Khalifa Ahmed Ben Slimene Hajer Blaiti Refka Kaddour Amjed Fekih Hassen Pierre Pardessus Christopher Brasher Souhayl Dahmani |
| author_sort | Sonia Ben Khalifa |
| collection | DOAJ |
| description | Abstract 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. ClinicalTrials.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. |
| first_indexed | 2024-04-24T07:12:48Z |
| format | Article |
| id | doaj.art-46d6f81336154f4cb3ff7a809b5c5fcd |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-24T07:12:48Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-46d6f81336154f4cb3ff7a809b5c5fcd2024-04-21T11:28:08ZengBMCBMC Anesthesiology1471-22532024-04-012411710.1186/s12871-024-02536-3The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled studySonia Ben Khalifa0Ahmed Ben Slimene1Hajer Blaiti2Refka Kaddour3Amjed Fekih Hassen4Pierre Pardessus5Christopher Brasher6Souhayl Dahmani7Department of Anesthesia and Intensive Care, Robert Ballanger HospitalDepartment of Anesthesia and Intensive Care, Children HospitalDepartment of Anesthesia and Intensive Care, Children HospitalDepartment of Anesthesia and Intensive Care, Robert Ballanger HospitalDepartment of Anesthesia and Intensive Care, Children HospitalUniversité de Paris-CitéDepartment of Anesthesia & Pain Management, Royal Children’s HospitalDepartment of Anesthesia and Intensive Care, Robert Ballanger HospitalAbstract 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. ClinicalTrials.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.https://doi.org/10.1186/s12871-024-02536-3DexamethasonePudendal blockChildrenHypospadias |
| spellingShingle | Sonia Ben Khalifa Ahmed Ben Slimene Hajer Blaiti Refka Kaddour Amjed Fekih Hassen Pierre Pardessus Christopher Brasher Souhayl Dahmani The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled study BMC Anesthesiology Dexamethasone Pudendal block Children Hypospadias |
| title | The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled study |
| title_full | The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled study |
| title_fullStr | The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled study |
| title_full_unstemmed | The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled study |
| title_short | The potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with Snodgrass technique: a randomized controlled study |
| title_sort | potentiating effect of intravenous dexamethasone upon preemptive pudendal block analgesia for hypospadias surgery in children managed with snodgrass technique a randomized controlled study |
| topic | Dexamethasone Pudendal block Children Hypospadias |
| url | https://doi.org/10.1186/s12871-024-02536-3 |
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