Comparing Dexamethasone, Dexmedetomidine, and Their Combination Added to Ropivacaine for Nerve Block Pain Relief in Children Undergoing Lower Leg or Foot Surgery

What this Trial Is About

This research aims to evaluate three commonly used medications added to a local anesthetic during a popliteal sciatic nerve block in children aged 3 to 12 years undergoing surgery on the lower leg or foot. The study compares dexamethasone, dexmedetomidine, and their combination to see if the combination provides longer pain relief and reduces the need for additional pain medication after surgery. It is a randomized, double-blinded, controlled clinical trial focused on improving postoperative comfort in pediatric patients. All children will receive a single injection of 0.2% ropivacaine for the nerve block under ultrasound guidance. Participants will be randomly assigned to one of three groups ropivacaine with dexamethasone, ropivacaine with dexmedetomidine, or ropivacaine with both dexamethasone and dexmedetomidine. The nerve block will be performed using a 22-gauge echogenic needle under sterile conditions before surgery, and all children will receive standard perioperative pain control. During the study, trained observers who do not know the group assignments will assess pain scores, block duration, opioid use, and recovery. Follow-up calls will occur one week and one month after surgery to check for nerve injury or other effects. The main outcome measured is the time until the first need for additional pain relief within 24 hours after surgery. Secondary measurements include opioid use, behavioral pain scores using FLACC at various times after surgery, adverse events, and early recovery of function.

Dexamethasone vs Dexmedetomidine vs Combination as Adjuvants to Popliteal Sciatic Nerve Block in Children