Dexamethasone shows a dose-dependent effect on speeding onset and increasing the duration of analgesia after interscalene block for shoulder surgery.

pearl

• Jae Hee Woo, Youn Jin Kim, Dong Yeon Kim, and Sooyoung Cho.
• From the Department of Anaesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
• Eur J Anaesthesiol. 2015 Sep 1; 32 (9): 650-5.

BackgroundDexamethasone prolongs the duration of single-shot interscalene brachial plexus block (SISB). However, dose-dependency of dexamethasone as an adjuvant for SISB remains insufficiently understood.ObjectiveThe objective of this study is to evaluate the effect of different doses of dexamethasone on the duration of SISB using ropivacaine 0.5%.DesignA randomised, double-blind controlled trial.SettingSingle university tertiary care centre.PatientsOne hundred and forty-four patients scheduled for elective arthroscopic shoulder surgery were allocated randomly to one of four groups.InterventionsPatients received 12 ml of ropivacaine 0.5% in 0.9% saline (control group), or containing dexamethasone 2.5, 5.0 or 7.5 mg for SISB.Main Outcome MeasuresThe primary endpoint was the time to the first analgesic request. Pain scores and adverse effects were also assessed up to 48 h postoperatively.ResultsInclusion of dexamethasone 2.5, 5.0 and 7.5 mg resulted in significant (P < 0.001) increases in time to the first analgesic request by factors of 1.6, 2.2 and 1.8, respectively. The percentages of patients not requiring analgesics in the first 48 h postoperatively with dexamethasone 0.0, 2.5, 5.0 and 7.5 mg were 3, 22, 39 and 33%, respectively (P < 0.001). There were no significant effects on pain scores or incidences of adverse effects.ConclusionDexamethasone demonstrated significant beneficial dose-dependent effects on duration to the first analgesic request, the number of patients not requiring analgesics and analgesic use in the first 48 h after SISB for arthroscopic shoulder surgery. There were no significant effects on pain scores or incidences of adverse effects.Trial Registrationthe trial was registered with the Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp. Identifier: KCT0001078.

This article appears in the collection: Does dexamethasone safely prolong peripheral nerve blocks?.

27 keywords...

hide…