الفهرس 
InroductionOnly 14 pages are availabe for public view
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Abstract
Caudal anesthesia is the one of most important pediatric regional anesthetic technique. The technique is relatively easy to learn has a remarkable safety record and can be used for a large variety of procedures.
It allows rapid recovery from anesthesia by reducing the requirement of other systemic anesthetic agents with effective postoperative analgesia .
One of the major disadvantages with caudal analgesia is the limited duration of analgesia following single injection. Various adjuvant like morphine, fentanyl, clonidine and ketamine have been used along with local anesthetic agents to prolong the duration of analgesia provided by the caudal epidural block.
Dexamethasone, a corticosteroid with strong antiinflammatory effects, provides postoperative analgesia and has shown improvement in morbidity such as nausea, vomiting, fever, and delayed oral intake in children.
This study evaluated the efficacy of intravenous dexamethasone 0.5 mg\kg in combination with a caudal block in augmentation of the intensity and duration of postoperative analgesia without adverse effects in children undergoing hypospadias repair surgury as regards hemodynamic, duration of analgesia, pain score, and adverse effects.
40 ASA status I and II patients aged 4 to 8 years underwent hypospadias repair surgery were prospectively enrolled in this study.
group 1 (Dexamethasone group): received intravenous dexamethasone 0.5mg kg combined with caudal bupivacaine0.25%(1mg\kg)
group 2 (control group) :received the same volume intravenous normal saline combined with caudal bupivacaine 0.25%(1mg\kg)
Basal Heart rate (H.R.) and blood pressure (B.P.) were recorded and every 5 minutes until the end of surgery and every ½ h for 2 hours and then for 2 hours until 12 hours. The FLACC pain score was used for assessment of pain in the children and were recorded postoperative with the hemodynamics.
Conclusion
Intravenous dexamethasone (0.5 mg kg) in combination with a caudal block augmented the intensity and duration of postoperative analgesia without adverse effects in children undergoing hypospadias repair surgery.