• Anaesthesia · Mar 2016

    Randomized Controlled Trial Comparative Study

    A randomised controlled trial of perineural vs intravenous dexamethasone for foot surgery.

    • R L Dawson, D H McLeod, J P Koerber, J L Plummer, and G C Dracopoulos.
    • Department of Anaesthesia, Flinders Medical Centre, Adelaide, South Australia, Australia.
    • Anaesthesia. 2016 Mar 1; 71 (3): 285-90.

    AbstractWe used 20 ml ropivacaine 0.75% for ankle blocks before foot surgery in 90 participants who we allocated in equal numbers to: perineural dexamethasone 8 mg and intravenous saline 0.9%; perineural saline 0.9% and intravenous dexamethasone 8 mg; or perineural and intravenous saline 0.9%. Dexamethasone increased the median (IQR [range]) time for the return of some sensation or movement, from 14.6 (10.8-18.8 [5.5-38.0]) h with saline to 24.1 (19.3-29.3 [5.0-44.0]) h when given perineurally, p = 0.00098, and to 20.9 (18.3-27.8 [8.8-31.3]) h when given intravenously, p = 0.0067. Dexamethasone increased the median (IQR [range]) time for the return of normal neurology, from 17.6 (14.0-21.0 [9.5-40.5]) h with saline to 27.5 (22.0-36.3 [7.0-53.0]) h when given perineurally, p = 0.00016, and to 24.0 (20.5-32.3 [13.0-42.5]) h when given intravenously, p = 0.0022. Dexamethasone did not affect the rates of block success, postoperative pain scores, analgesic use, or nausea and vomiting. The route of dexamethasone administration did not alter its effects.© 2015 The Association of Anaesthetists of Great Britain and Ireland.

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


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