Dose-dependency of dexamethasone on the analgesic effect of interscalene block for arthroscopic shoulder surgery using ropivacaine 0.5%. Issue 9 (September 2015)

• Record Type: Journal Article
• Authors: Woo, Jae Hee; Kim, Youn Jin; Kim, Dong Yeon; Cho, Sooyoung
• Is Part Of: European journal of anaesthesiology. Volume 32:Issue 9(2015:Sep.)
• Publication Date: 2015-09
• Subjects: Anesthesiology -- Periodicals; Anesthesiology -- Periodicals; Anesthésiologie -- Périodiques; Anesthesiology; Periodicals; Electronic journals; 617.96
• DOI: 10.1097/EJA.0000000000000213
• Languages: English
• ISSNs: 0265-0215

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>BACKGROUND</title> <p>Dexamethasone prolongs the duration of single-shot interscalene brachial plexus block (SISB). However, dose-dependency of dexamethasone as an adjuvant for SISB remains insufficiently understood.</p> </sec> <sec> <title>OBJECTIVE</title> <p>The objective of this study is to evaluate the effect of different doses of dexamethasone on the duration of SISB using ropivacaine 0.5%.</p> </sec> <sec> <title>DESIGN</title> <p>A randomised, double-blind controlled trial.</p> </sec> <sec> <title>SETTING</title> <p>Single university tertiary care centre.</p> </sec> <sec> <title>PATIENTS</title> <p>One hundred and forty-four patients scheduled for elective arthroscopic shoulder surgery were allocated randomly to one of four groups.</p> </sec> <sec> <title>INTERVENTIONS</title> <p>Patients 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.</p> </sec> <sec> <title>MAIN OUTCOME MEASURES</title> <p>The primary endpoint was the time to the first analgesic request. Pain scores and adverse effects were also assessed up to 48 h postoperatively.</p> </sec> <sec> <title>RESULTS</title> <p>Inclusion of dexamethasone 2.5, 5.0 and 7.5 mg resulted in significant (<italic>P</italic> < 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 (<italic>P</italic> < 0.001). There were no significant effects on pain scores or incidences of adverse effects.</p> </sec> <sec> <title>CONCLUSION</title> <p>Dexamethasone 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.</p> </sec> <sec> <title>TRIAL REGISTRATION</title> <p>the trial was registered with the Clinical Trial Registry of Korea: https://cris.nih.go.kr/cris/index.jsp. Identifier: KCT0001078</p> </sec> </abstract>