• Elisabeth Hoerner, Lukas Gasteiger, Michael Ortler, Vitaliy Pustilnik, Simon Mathis, Christine Brunner, Sabrina Neururer, Andreas Schlager, Daniel Egle, and Guenther Putz.
• Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Austria.
• J Clin Anesth. 2022 May 1; 77: 110622.

Study ObjectiveDexamethasone is commonly used as an adjuvant to local anesthetics to prolong duration of peripheral nerve blocks with minimal side-effects. The present study investigates the efficacy of dexamethasone added to ropivacaine 0.2% as compared to ropivacaine 0.2% alone for pectoral nerves block II (PECS II) in unilateral radical mastectomy.DesignA prospective, randomized, controlled and double-blinded trial.SettingThe study was performed at Innsbruck Medical University Hospital, Austria, between January 2019 and October 2020.PatientsSixty female patients with an American Society of Anesthesiologists Score I-II (18-90 years, BMI 18-35) scheduled for unilateral radical mastectomy without one-stage immediate autologous breast reconstruction were randomly assigned to receive PECS II block with ropivacaine 0.2% with or without dexamethasone 8 mg.InterventionsPatients were randomly assigned to receive PECS II block with ropivacaine 0.2% with or without dexamethasone 8 mg.MeasurementsPrimary outcome parameter was the cumulative opioid consumption during the first 72 postoperative hours. Secondary outcome parameters were the duration of analgesia and the course of the visual analogue scale (VAS) and the area under the curve VAS (AUC-VAS).Main ResultsThere was no difference in cumulative opioid consumption after 72 h between the ropivacaine 0.2% plus dexamethasone group and the ropivacaine 0.2% plus placebo group (11.89 vs 11.90 morphine milligram equivalent, respectively; p 0.831). Duration of analgesia also did not differ significantly between the ropivacaine 0.2% plus dexamethasone group and the ropivacaine 0.2% plus placebo group (12.75 versus 8.75 h, respectively; p 0.680). There also was no difference in the course of VAS and AUC-VAS.ConclusionsDexamethasone 8 mg when added to ropivacaine 0.2% for PECS II block in unilateral radical mastectomy was not found to reduce total opioid consumption over 72 postoperative hours or to prolong duration of analgesia as compared to pure ropivacaine 0.2%.Copyright © 2021 Elsevier Inc. All rights reserved.

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