Vol 7: Perineural but not systemic low-dose dexamethasone prolongs the duration of interscalene block with ropivacaine: a prospective randomized trial.Reportar como inadecuado



 Vol 7: Perineural but not systemic low-dose dexamethasone prolongs the duration of interscalene block with ropivacaine: a prospective randomized trial.


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This article is from Local and Regional Anesthesia, volume 7.AbstractPurpose: To determine the effects of intravenous and perineural dexamethasone on the duration of interscalene brachial plexus block ISB with ropivacaine in patients undergoing arthroscopic shoulder surgery. Patients and methods: In this prospective, randomized, placebo-controlled trial, patients presenting for arthroscopic shoulder surgery with an ISB were randomized to receive ropivacaine 0.75% group C, ropivacaine 0.75% plus perineural dexamethasone 4 mg group Dperi, or ropivacaine 0.75% plus intravenous dexamethasone 4 mg group Div. The primary outcome was the duration of analgesia, defined as the time between performance of the block and the first request for analgesic. Results: Thirty-nine patients were randomized. The median times of sensory block in groups C, Dperi, and Div were 11.2 hours interquartile range IQR 8.0–15.0 hours, 18.0 hours IQR 14.5–19.0 hours, and 14.0 hours IQR 12.7–15.1 hours, respectively. Significant differences were observed between groups Dperi and C P=0.001. Kaplan–Meier analysis for the first analgesic request showed significant differences between groups Dperi and C P=0.005 and between groups Dperi and Div P=0.008, but not between groups C and Div. Conclusion: Perineural but not intravenous administration of 4 mg of dexamethasone significantly prolongs the duration of effective postoperative analgesia resulting from a single-shot ISB with ropivacaine 0.75%.



Autor: Kawanishi, Ryosuke; Yamamoto, Kaori; Tobetto, Yoko; Nomura, Kayo; Kato, Michihisa; Go, Ritsuko; Tsutsumi, Yasuo M; Tanaka, Katsuya; Takeda, Yoshitsugu

Fuente: https://archive.org/







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