Comparing Dexamethasone Delivery Methods and Local Anesthetic Levels for Pain and Inflammation Control in Children Undergoing Scoliosis Surgery

What this Trial Is About

Scoliosis correction surgery in children is a complex procedure with risks such as postoperative pain, inflammation, and possible neurological complications. Effective pain management and reducing inflammation are important for faster recovery and better outcomes. Dexamethasone is often used alongside regional anesthesia because of its anti-inflammatory effects and ability to extend pain relief. This study compares different ways of giving dexamethasone intravenous versus perineural and local anesthetic concentrations to find the best approach for pain control, inflammation, and nerve monitoring during surgery in children. The study evaluates two treatment approaches Erector Spinae Plane Block with 0.2% ropivacaine combined either with perineural dexamethasone at 0.1 mgkg or intravenous dexamethasone at the same dose. The study is randomized and quadruple-masked to compare these interventions during scoliosis surgery in children aged 10 to 18 years. Researchers will observe the effects of these techniques on pain, inflammatory markers, and neuromonitoring parameters throughout the surgical and postoperative periods. Participants will be closely monitored with assessments including the time until first rescue opioid use within 48 hours after surgery, pain scores at multiple time points after surgery, intraoperative drug requirements, neuromonitoring signals, and inflammatory response markers like neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios. The study aims to optimize anesthesia protocols to improve safety and recovery after pediatric scoliosis surgery. Total participation includes surgery and follow-up assessments up to 48 hours postoperatively.

The Effect of Dexamethasone Administration Route and Local Anesthetic Concentration on Pain, Inflammatory Response, and Neuromonitoring in Children Undergoing Scoliosis Correction