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

Objective: To assess the effect of a preoperative single dose of dexamethasone associated with penile block on pain after circumcision.

Study Design: Prospective randomized controlled study.

Patients And Methods: 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.

Results: 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).

Conclusion: 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.