Prophylactic Effects of Intravenous Dexamethasone and Lidocaine on Attenuating Hemodynamic-Respiratory and Pain Complications in Children Undergoing Cleft Palate Repair Surgery With General Anesthesia

Abstract

This study aimed to compare the prophylactic effects of intravenous (IV) dexamethasone and lidocaine on hemodynamic condition, respiratory complications, pain control, and vomit incidence following cleft palate repair surgery. This double-blind randomized controlled trial was carried out on 87 children assigned to three groups. Prior to anesthesia, subjects in groups D and L received 0.2 and 1 mg/kg IV dexamethasone and lidocaine, respectively. Moreover, group C received placebo in a similar condition. The outcome variables were recorded prior to the surgery and then every 15 minutes during the surgical and recovery time. Mean heart rate (HR), mean arterial blood pressure (MABP), and mean end-tidal carbon dioxide (ETCO2) during the surgical time were not significantly different between dexamethasone and lidocaine groups. Dexamethasone significantly improved the level of blood oxygen saturation (SPO2) during the recovery time. Nevertheless, MABP in recovery time did not significantly decrease in the dexamethasone group. There were no significant differences in respiratory complications, pain score, and vomiting incidence between lidocaine and dexamethasone groups. Premedication with both IV dexamethasone and lidocaine provided similar stable hemodynamic and respiratory conditions during the surgical time. However, the use of dexamethasone developed more desirable effects on HR and SPO2 than administration of lidocaine during the recovery time. Both drugs significantly lessened postoperative pain compared to the placebo group at this time.

Keywords:

• Cleft palate
• general anesthesia
• dexamethasone
• lidocaine
• postoperative complications

Acknowledgments

The authors would like to thank the patients, their parents, and authorities of Imam Hossein Hospital in Isfahan for their cooperation with this study. Moreover, the authors would like to thank Dr. Amir Mohammad Nourbakhsh for language editing.

Declaration of interest

All authors disclose no conflict of interest regarding this manuscript content.

Author disclosures

No disclosures to declare.

Funding

This study was supported by a research grant from the fluid research fund of the Vice-Chancellor for Research of Isfahan University of medical sciences.

Financial Disclosures: No disclosures to declare.

Conflict of interest: All authors disclose no conflict of interest regarding this manuscript content.

Data sharing statement: De-identified individual participant data will not be made available.