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CompletedNCT04841018Updated Sep 14, 2023

Does Low Dose of Dexamethasone Enhance Analgesic Quality of Caudal Analgesia in Children Undergoing Orchiopexy?

An interventional study of High dose dexamethasone and Low dose dexamethasone in Patients With Cryptorchism Who Are Planning to Undergo Orchiopexy, sponsored by Yonsei University. Completed at 1 site in Korea, Republic of. Open to male participants aged 6 Months to 6 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-09-14.

Sponsored by Yonsei University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
273
Allocation
Randomized
Ages
6 Months to 6 Years
Sex
Male
01

Study summary

Caudal block is one of the most effective modalities to reduce pain both during and after the surgery involving areas under the umbilicus. According to previous research, 0.5mg/kg-1.5mg/kg dexamethasone is known to enhance the analgesic quality of caudal block in children. Despite the fact that this high dose of dexamethasone is used to treat airway edema in actual practice and no adverse side effect related to dosage has been reported, it is 3 to 15 times higher than the daily antiemetic dose of dexamethasone that is used in standard care of anesthesia. Therefore, our study aims to assess the effect of the more practical, antiemetic dose of dexamethasone (0.15mg/kg) as an adjuvant to enhance the quality of caudal block through a non-inferiority trial.

02

Conditions studied

  • Patients With Cryptorchism Who Are Planning to Undergo Orchiopexy

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Keywords

  • caudal block
  • low dose dexamethasone
  • postoperative pain
03

Who can participate

Ages eligible
6 Months to 6 Years
Sexes eligible
Male
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Ages from 6 months old to 6 years old
  2. Body weight Less than or equal to 16.7kg
  3. American Society of Anesthesiologists (ASA) classification I or II
  4. Patients receiving orchiopexy under general anesthesia

Exclusion criteria

Exclusion Criteria:

  1. Patients with uncorrected cardiac anomalies
  2. Patients with vertebral anomalies
  3. Diagnosis of diabetes mellitus
  4. Diagnosis of adrenal disease
  5. Currently on steroid
  6. Body temperature above 37.5'C preoperatively
  7. Allergy to dexamethasone
  8. Laparoscopic surgery
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
273 participants (actual)

Study arms

  • Experimental
    Control

    Higher dose of dexamethasone (0.5mg/kg) that is known to enhance the analgesic quality of caudal block from previous study

    Drug: High dose dexamethasone

  • Experimental
    Dexamethasone

    Lower, antiemetic dose of dexamethasone (0.15mg/kg)

    Drug: Low dose dexamethasone

Interventions

  • DrugHigh dose dexamethasone

    After caudal block with 1.2ml/kg of 0.15% ropivacaine, the patient receives 0.5mg/kg of intravenous dexamethasone

  • DrugLow dose dexamethasone

    After caudal block with 1.2ml/kg of 0.15% ropivacaine, the patient receives 0.15mg/kg of intravenous dexamethasone

05

What researchers measure

Primary outcomes

  1. The need for additional analgesics during the first 48 hrs after surgery

    The child's parent is to be educated prior to the surgery so that when the pain score (FLACC or Wong-Baker Faces Scale) is 4 or above at home, he or she receives an additional acetaminophen. The outcome assessor calls or text messages the parent at 6 hours, 24 hours, and 48 hours after the surgery to assess the need for additional analgesics until 48 hours after the surgery.

    Time frame: Until 48 hours after the surgery

Secondary outcomes

  1. Time to the first additional analgesic

    The outcome assessor calls or text messages the parent at 6 hours, 24 hours, and 48 hours after the surgery to find out when the first acetaminophen was given and how many times in total it was given to the child. Also, the pain scores (FLACC, Wong-Baker Faces Scale, Parent Postoperative Pain Measure) and the satisfaction scores were obtained at each time point.

    Time frame: Until 48 hours after the surgery

  2. total number of additional analgesic

    The outcome assessor calls or text messages the parent at 6 hours, 24 hours, and 48 hours after the surgery to find out when the first acetaminophen was given and how many times in total it was given to the child. Also, the pain scores (FLACC, Wong-Baker Faces Scale, Parent Postoperative Pain Measure) and the satisfaction scores were obtained at each time point.

    Time frame: Until 48 hours after the surgery

  3. pain score at each time point

    The outcome assessor calls or text messages the parent at 6 hours, 24 hours, and 48 hours after the surgery to find out when the first acetaminophen was given and how many times in total it was given to the child. Also, the pain scores (FLACC, Wong-Baker Faces Scale, Parent Postoperative Pain Measure) and the satisfaction scores were obtained at each time point.

    Time frame: Until 48 hours after the surgery

  4. scale of satisfaction at each time point

    The outcome assessor calls or text messages the parent at 6 hours, 24 hours, and 48 hours after the surgery to find out when the first acetaminophen was given and how many times in total it was given to the child. Also, the pain scores (FLACC, Wong-Baker Faces Scale, Parent Postoperative Pain Measure) and the satisfaction scores were obtained at each time point.

    Time frame: Until 48 hours after the surgery

06

Study locations

1 site
  • Yonsei University Health System, Severance Hospital
    Seoul, Korea, Republic of
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04841018
Lead sponsor
Yonsei University
Responsible party
Sponsor
First posted
Apr 12, 2021
Start date
Mar 24, 2021
Primary completion
Aug 29, 2023
Completion
Sep 1, 2023
Last update
Sep 14, 2023

Study contacts

Jeong-Rim Lee
principal investigator · Severance Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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