Effect of a single intramuscular dose of dexamethasone on pain after circumcision. A randomized controlled study

• Published in: Annales françaises d'anesthésie et de réanimation Vol. 32; no. 2; pp. 98 - 103
• Main Authors: Aissaoui, Y, Chkoura, K, Zaini, R, Moujahid, M, Mergad, O, Boughalem, M
• Format: Journal Article
• Language: French
• Published: France 01.02.2013
• Subjects: Anesthesia, General; Anti-Inflammatory Agents - therapeutic use; Child, Preschool; Circumcision, Male - adverse effects; Dexamethasone - therapeutic use; Humans; Kaplan-Meier Estimate; Male; Nerve Block; Pain Measurement - drug effects; Pain, Postoperative - drug therapy; Postoperative Care; Sleep; Treatment Outcome
• ISSN: 1769-6623
• DOI: 10.1016/j.annfar.2012.12.007

To assess the effect of a preoperative single dose of dexamethasone associated with penile block on pain after circumcision. Prospective randomized controlled study. Forty male children aged 2 to 5 years, scheduled for circumcision under general anaesthesia, combined with penile block, were randomized into two groups. The dexamethasone group received dexamethasone 0.4 mg/kg preoperatively. The control group received the same volume of normal saline. Data compared between two groups were: postoperative pain assessed by the Objective Pain Scale collected in the recovery room, at 8 and 24 hours postoperatively (h0, h8 and h24), time to first analgesic request and the quality of sleep on the first postoperative night. Pain scores at h0 were similar between the two groups. The dexamethasone group showed significantly lower pain scores at h8 [0 (0-1) vs. 2 (0-3); P=0.04] and h24 [0 (0-0) vs. 0 (0-1); P=0.02]. The time to first analgesic administration was also significantly delayed in the dexamethasone group compared to the control group (240 vs 180 min; P=0.035). The quality of sleep was also better in children in the dexamethasone group (P=0.018). This study showed that the combination of a preoperative single dose of dexamethasone 0.4 mg/kg with penile block significantly improves the quality of analgesia after circumcision.