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Created September 13, 2015, last updated almost 7 years ago.
Collection: 54, Score: 1476, Trend score: 0, Read count: 1489, Articles count: 8, Created: 2015-09-13 10:20:22 UTC. Updated: 2016-04-12 04:52:52 UTC.Notes
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Collected Articles
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Acta Anaesthesiol Scand · Jul 2014
Randomized Controlled Trial Comparative StudyDexamethasone for pain after outpatient shoulder surgery: a randomised, double-blind, placebo-controlled trial.
Preoperative IV dexamethasone reduces pain after arthroscopic shoulder surgery.
pearl -
Review Meta Analysis
Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis.
Intraoperative dexamethasone produces a small, though clinically insignificant post-operative analgesic benefit.
pearl -
Reg Anesth Pain Med · Jul 2015
Randomized Controlled TrialAddition of Dexamethasone and Buprenorphine to Bupivacaine Sciatic Nerve Block: A Randomized Controlled Trial.
Sciatic nerve block provides analgesia after foot and ankle surgery, but block duration may be insufficient. We hypothesized that perineural dexamethasone and buprenorphine would reduce pain scores at 24 hours. ⋯ Pain scores were very low at 24 hours after surgery in the context of multimodal analgesia and were not improved by additives. However, perineural buprenorphine and dexamethasone prolonged block duration, reduced the worst pain experienced, and reduced opioid use. Intravenous buprenorphine caused troubling nausea and vomiting. Future research is needed to confirm and extend these observations.
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Review Meta Analysis
Combination of dexamethasone and local anaesthetic solution in peripheral nerve blocks: A meta-analysis of randomised controlled trials.
Dexamethasone doubled the duration of postoperative analgesia after brachial plexus block, as well as speeding onset and reducing PONV.
pearl -
Anesthesia and analgesia · May 2014
Randomized Controlled TrialThe Effects of Perineural Versus Intravenous Dexamethasone on Sciatic Nerve Blockade Outcomes: A Randomized, Double-Blind, Placebo-Controlled Study.
Neither IV or perineural dexamethasone as part of a sciatic nerve block improved the quality of surgical recovery, but did prolong block duration.
pearl -
Anesthesia and analgesia · Jan 2013
Review Meta AnalysisDexamethasone to prevent postoperative nausea and vomiting: an updated meta-analysis of randomized controlled trials.
Dexamethasone provides effective PONV prophylaxis (NNT 3.7). There is however no benefit of an 8 to 10 mg IV dose over a lower 4 to 5 mg dose.
pearl -
Anesthesia and analgesia · Jan 2006
Randomized Controlled Trial Comparative StudyDexamethasone added to lidocaine prolongs axillary brachial plexus blockade.
Different additives have been used to prolong regional blockade. We designed a prospective, randomized, double-blind study to evaluate the effect of dexamethasone added to lidocaine on the onset and duration of axillary brachial plexus block. Sixty patients scheduled for elective hand and forearm surgery under axillary brachial plexus block were randomly allocated to receive either 34 mL lidocaine 1.5% with 2 mL of isotonic saline chloride (control group, n = 30) or 34 mL lidocaine 1.5% with 2 mL of dexamethasone (8 mg) (dexamethasone group, n = 30). ⋯ The duration of surgery and the onset times of sensory and motor block were similar in the two groups. The duration of sensory (242 +/- 76 versus 98 +/- 33 min) and motor (310 +/- 81 versus 130 +/- 31 min) blockade were significantly longer in the dexamethasone than in the control group (P < 0.01). We conclude that the addition of dexamethasone to lidocaine 1.5% solution in axillary brachial plexus block prolongs the duration of sensory and motor blockade.
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Randomized Controlled Trial Comparative Study
Perineural versus intravenous dexamethasone as adjuncts to local anaesthetic brachial plexus block for shoulder surgery.
This randomised, double-blind, placebo-controlled study compared the effect of perineural with intravenous dexamethasone, both administered concomitantly with interscalene brachial plexus block for shoulder surgery. Patients received 8 mg dexamethasone mixed with ropivacaine in the block injection (n = 42), 8 mg dexamethasone intravenously at the time of the block (n = 37), or intravenous saline (n = 41) at the time of the block. Perineural and intravenous dexamethasone resulted in prolonged mean (SD) duration of block to 16.9 (5.2) h and 18.2 (6.4) h, respectively, compared with 13.8 (3.8) h for saline (p = 0.001). ⋯ Dexamethasone via either route reduced anti-emetic use (p = 0.046). There was no effect on patient satisfaction. These results suggest that both perineural and intravenous dexamethasone are useful adjuncts to ropivacaine interscalene block, with the intravenous route preferred as this avoids the possibility of neural toxicity of dexamethasone.
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