Dexamethasone as a ropivacaine adjuvant for ultrasound-guided interscalene brachial plexus block: A randomized, double-blinded clinical trial - 18/04/17
, Patricia Marchioro c , Fabiana Schuelter-Trevisol a, b , Daisson José Trevisol a, b Abstract |
Study objective |
The purpose of this study was to evaluate the effect of intravenous or perineural dexamethasone added to ropivacaine on the duration of ultrasound-guided interscalene brachial plexus blocks (BPB).
Design |
Randomized clinical trial.
Setting, patients and interventions |
Sixty ASA physical status I–II patients with elective shoulder arthroscopic surgeries under interscalene brachial plexus blocks were randomly allocated to receive 20ml of 0.75% ropivacaine with 1ml of isotonic saline (C group, n=20), 20ml of 0.75% ropivacaine with 1ml (4mg) of perineural dexamethasone (Dpn group, n=20), or 20ml of 0.75% ropivacaine with 1ml of isotonic saline and intravenous 4mg dexamethasone (IV) (Div group, n=20). A nerve stimulation technique with ultrasound was used in all patients.
Measurements |
The onset time and duration of sensory blocks were assessed. Secondary outcomes were pain scores (VAS) and postoperative vomiting and nausea (PONV).
Main results |
The duration of the motor and sensory block was extended in group Dpn compared with group Div and group C (P<0.05). In addition, within 24h, group Dpn presented lower levels of VAS and lower incidence of PONV as compared with the other groups. Moreover, there was a significant reduction on onset time between group Dpn and the other groups.
Conclusions |
Perineural 4mg dexamethasone was more effective than intravenous in extending the duration of ropivacaine in ultrasound-guided interscalene BPB. Moreover, Dpn has significant effects on onset time, PONV, and VAS.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The effect of intravenous or perineural dexamethasone added to ropivacaine on the duration of ultrasound-guided interescalene brachial plexus block |
• | Dexamethasone (perineural and intravenous) extended duration of the motor and sensory block |
• | Perineural group presented lower levels of Visual Analogic Scale (VAS) score and lower incidence of postoperative nausea and vomiting |
• | Intravenous group did not reduce VAS score, Postoperative opioid 24hs need and PONV. |
Keywords : Analgesia, Brachial plexus block, Dexamethasone, Bupivacaine, Ultrasound, Shoulder
Plan
| ☆ | This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. |
| ☆☆ | Registration: RBR-86mhm2/. |
Vol 38
P. 133-136 - mai 2017 Retour au numéro
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