Analgesic efficacy of caudal dexamethasone combined with ropivacaine in children undergoing orchiopexy

Br J Anaesth. 2014 May;112(5):885-91. doi: 10.1093/bja/aet484. Epub 2014 Feb 2.


Background: Epidural administration of dexamethasone might reduce postoperative pain in adults. We evaluated whether a caudal block of 0.1 mg kg(-1) dexamethasone combined with ropivacaine improves analgesic efficacy in children undergoing day-case orchiopexy.

Methods: This randomized, double-blind study included 80 children aged 6 months to 5 yr who underwent day-case, unilateral orchiopexy. Patients received either 1.5 ml kg(-1) of 0.15% ropivacaine (Group C) or 1.5 ml kg(-1) of 0.15% ropivacaine in which dexamethasone of 0.1 mg kg(-1) was mixed (Group D) for caudal analgesia. Postoperative pain scores, rescue analgesic consumption, and side-effects were evaluated 48 h after operation.

Results: Postoperative pain scores at 6 and 24 h post-surgery were significantly lower in Group D than in Group C. Furthermore, the number of subjects who remained pain free up to 48 h after operation was significantly greater in Group D [19 of 38 (50%)] than in Group C [four of 37 (10.8%); P<0.001]. The number of subjects who received oral analgesic was significantly lower in Group D [11 of 38 (28.9%)] than in Group C [20 of 37 (54.1%); P=0.027]. Time to first oral analgesic administration after surgery was also significantly longer in Group D than in Group C (P=0.014). Adverse events after surgery including vomiting, fever, wound infection, and wound dehiscence were comparable between the two groups.

Conclusions: The addition of dexamethasone 0.1 mg kg(-1) to ropivacaine for caudal block can significantly improve analgesic efficacy in children undergoing orchiopexy. Clinical trial registration NCT01604915.

Keywords: anaesthetic techniques, regional, caudal; analgesia, postoperative; hormones, corticosteroid; paediatrics; surgery, day-case.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amides*
  • Anesthesia, Caudal / methods*
  • Anesthetics, Combined*
  • Anesthetics, Local*
  • Anti-Inflammatory Agents*
  • Child, Preschool
  • Dexamethasone*
  • Double-Blind Method
  • Humans
  • Infant
  • Male
  • Orchiopexy / methods*
  • Pain Measurement / methods
  • Pain, Postoperative / drug therapy
  • Prospective Studies
  • Ropivacaine
  • Treatment Outcome


  • Amides
  • Anesthetics, Combined
  • Anesthetics, Local
  • Anti-Inflammatory Agents
  • Ropivacaine
  • Dexamethasone

Associated data