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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionApplication for ESRA Abstract PrizesBackground and Aims In paediatric male circumcision, caudal block (CB) is considered as a reliable, effective technique. Despite increasing interest, the dorsal penile nerve block (DPNB) provided less intra- and postoperative analgesia than CB. Intravenous (iv) dexamethasone, an increasingly used adjunct in regional anaesthesia, has been associated with prolonged block duration. However, its role in increased DPNB efficacy remains unclear. The aim of this study is to investigate whether intravenous dexamethasone increases the analgesic efficacy of the DPNB, measured by the Face, Legs, Activity, Cry, Consolability (FLACC) scale scores during the first 24 postoperative hours.Methods Fifty-four patients, aged 1 to 6 years old, scheduled for circumcision were randomized into 3 groups: group 1 (CB 0.5 ml/kg levobupivacaine 0,25% with iv dexamethasone (CB + DXM, n = 18)), group 2 (DPNB 0.2 ml/kg levobupivacaine 0,5% with iv dexamethasone (DPNB + DXM, n = 21)) and group 3 (DPNB 0.2 ml/kg levobupivacaine 0,5% without dexamethasone (DPNB, n = 15)). The primary outcome is the FLACC score at predefined timepoints (30 minutes, 1, 2, 6, 12 and 24 hours after surgery) during the first 24 postoperative hours.Results Using a cumulative link mixed model, the odds for lower FLACC scores were not significantly different between the 3 groups using group 1 as reference (group 2: 0.636 [- 0.285 – 1.558; p = 0.176] & group 3: 0.641 [-0.344 – 1.625; p = 0.202]).Abstract P306 Figure 1CONSORT flow diagramAbstract P306 Table 1Demographics by treatment groupAbstract P306 Figure 2Predicted FLACC score probabilities per treatment allocation. CB + DXM: caudal block with iv dexamethasone; DPNB: dorsal penile nerve block without iv dexamethasone; DPNB + DXM: dorsal penile nerve block with iv dexamethasoneConclusions Using intravenous dexamethasone as an adjunct in a DPNB does not increase the odds for lower FLACC scores during the first 24 postoperative hours after paediatric circumcision.