Effect of systematic dexamethasone on the duration of popliteal nerve block after pediatric ankle/foot surgery
This study is proposed to explore the effect of systemic dexamethasone on the duration of popliteal nerve block for analgesia after pediatric ankle surgery. After ankle or foot surgery, children need good analgesia. Peripheral nerve blocks have provided a safe, effective method to control early postoperative pain when symptoms are most severe. The safety of local anesthesia is particularly important in children due to the much lower toxicity threshold of local anesthetics. The use of an effective adjuvant, such as Dexamethasone, could allow for the use of a higher dilution of local anesthetics while maintaining and enhancing their analgesic effect. There is multiple research where intravenous and perineural dexamethasone use has been compared in adults. However, there is a huge lack of research regarding children. In this study, investigators compare different doses of systemic dexamethasone. Before the anesthesia, the patients receive dexamethasone intravenously. Groups 2 and 3 have dexamethasone doses of 0.1mg/kg, and 0.2mg/kg. The investigator's goal is to find a dexamethasone dose that is as low as possible but at the same time covers the need for good pain relief and fast recovery postoperatively.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
90
administration of 5ml 0,9% sodium chloride - 30 minutes before the popliteal nerve block
administration of 0,1mg/kg Dexamethasone - 30 minutes before the popliteal nerve block
administration of 0,2mg/kg Dexamethasone - 30 minutes before the popliteal nerve block
Department of Spine Diseases and Pediatric Orthopedics, University of Medical Sciences, Poznań, Poland
Poznan, Wielkopolska, Poland
Poznan Univesity of Medical Sciences
Poznan, Wielkopolska, Poland
first need of opiate
Time after surgery when the patient needs opiate for the first time
Time frame: 48 hours
Opioid Consumption
Total opiate consumption after surgery
Time frame: 48 hours
Pain score
children \<3years old FLACC score (Face, Legs, Activity, Cry, Consolability) children \>3years old NRS (Numerical Rating Scale)
Time frame: 4 hours, 8 hours, 12 hours, 16 hours, 18 hours, 24 hours, 28 hours, 32 hours, 36 hours, 40 hours, 44 hours, 48 hours after surgery
Blood glucose
Blood glucose every 24 hour during hospitalization
Time frame: 24 and 48 hours after surgery
NLR
Neutrophil-to-lymphocyte ratio
Time frame: 24 and 48 hours after surgery
PLR
Platelet-to-lymphocyte ratio
Time frame: 24 and 48 hours after surgery
Mobilisation
Toe movement every 4 hours
Time frame: 4 hours, 8 hours, 12 hours, 16 hours, 18 hours, 24 hours, 28 hours, 32 hours, 36 hours, 40 hours, 44 hours, 48 hours after surgery
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