Hypospadias is a congenital malformation that occurs in an embryological process, and occurs with an incidence of about 1/300 in male children. The caudal block was the most commonly performed method for pain control after hypospadias surgery, and showed very good analgesic effect in the immediate postoperative stage. However, the caudal block is a neuraxial block that has a limitation in its duration with single shot and shows complications and adverse effects. In recent studies, the pudendal nerve block has been suggested as an alternative method. In children undergoing hypospadias surgery, the pudendal nerve block showed a longer duration compared to the caudal block, decreased the use of analgesics within 24 hours after surgery, and showed higher parental satisfaction. On the other hand, there have been many studies to prolong the duration of the relatively short duration of caudal block. Among them, dexamethasone administered intravenously is known to improve the duration of various regional blocks and reduce the administration of additional analgesics. The aim of this study is to verify whether a single administration of dexamethasone can enhance the effect of the pudendal nerve block in children 0.5-3 years of age undergoing hypospadias surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
46
2cc of normal saline is administered to patient instead of dexamethasone.
dexamethasone is administered 0.5mg/kg (up to 10mg) which is diluted with normal saline to make a total of 2cc.
Yonsei University Health System, Severance Hospital
Seoul, South Korea
the duration from surgery to first PCA(patient-controlled analgesia) administration
the very first time of PCA usage after surgery, which is automatically recorded in PCA.
Time frame: during 48 hours after surgery
the amount of additional analgesia required for postoperative 48hrs.
the amount of PCA usage for 48 hrs after surgery, which is automatically recorded in PCA.
Time frame: during 48 hours after surgery
the number of additional analgesia required for postoperative 48hrs.
the number of PCA usage for 48 hrs after surgery, which is automatically recorded in PCA.
Time frame: during 48 hours after surgery
pain score for each time period
ask parents about their children's pain score at each time point
Time frame: during 48 hours after surgery
overall parents' satisfaction questionnaire
at 48 hours after surgery, parents are asked about satisfaction of their children's pain control
Time frame: 48 hours after surgery
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