The Effect of Dexamethasone and Nebulised L-Epinephrine in Treatment of Croup

Croup is a common respiratory problem presenting to emergency department and there are many treatment methods for this disease. The aim of this study was to determine the effect of dexamethasone and dexamethasone with nebulised L-epinephrine in treatment of croup. In this clinical trial study، patients with mild to moderate croup enrolled in two groups by random sampling. Forty nine patients received intramuscular dexamethasone and normal saline nebulizer (3ml normal saline) and 48 patients received intramuscular dexamethasone (at a single dose of 0. 6mg/kg) and nebulized epinephrine (0. 5ml and 1ml of 1:1000 solution in 3ml normal saline for less and more than 10kg weight، respectively. We used Geelhoed scoring for croup scoring in this study. Before treatment and 30 and 60 minutes after treatment، croup score and respiratory rate per minute has been calculated for each patient and age، gender، duration of stay in the emergency ward and hospitalization status were recorded. (IRCT: 201105264396N2) Mean age of patients in the dexamethasone+ normal saline nebulizer group was 27. 8±19. 7 months and in the dexamethasone group+ epinephrine nebulizer was 24. 6? 18 months (p=0. 412). There was no significant difference in sex distribution of children in both groups (p>0. 05). Significant difference between the two treatment groups at baseline was not found for croup score but significant differences between croup score at 30 (p=0. 006) and 60 min (p=0. 031) in the two treatments. Respiratory rate before and after treatment showed no significant difference between the two groups. The average reduction rate at 60 min after treatment in compared to before treatment in epinephrine + dexamethasone group was 5. 6? 1. 1 and in dexamethasone + placebo group was 3. 7? 0. 2. Risk of hospitalization in the two groups was not significant. Results showed that adding nebulized epinephrine to croup treatment with dexamethasone had better response for this disease.