Effect of perineural dexamethasone as adjunct to ropivacaine in PENG block on postoperative pain, surgical stress, and opioid-sparing effect in paediatric hip surgeries – A prospective randomised controlled trial
Shibani Padhy, Akhya Kumar Kar, Gunnam Poojitha Reddy, Randheer K. AnnaramABSTRACT
Background and Aims:
Paediatric hip reconstruction produces intense postoperative pain and stress, often requiring opioids. This study evaluated if adding perineural dexamethasone to ropivacaine prolongs pericapsular nerve group (PENG) block duration and modulates postoperative inflammatory stress.
Methods:
In a double-blind randomised trial, 65 children (1–5 years) undergoing hip reconstruction received ultrasound-guided PENG block with 0.2% ropivacaine 0.5 mL/kg plus 0.1 mg/kg dexamethasone (Group A,
Results:
The median time to first rescue analgesia was not reached in Group A within 48 hours, versus 10.0 hours [95% confidence interval (CI): 8.4 to 11.1] in Group B [hazard ratio (HR) 0.21;
Conclusion:
Perineural dexamethasone significantly prolongs PENG block analgesia, reduces opioid exposure, and attenuates postoperative increases in NLR and PLR in children undergoing hip reconstruction.