Dexamethasone as a ropivacaine adjuvant for ultrasound-guided interscalene brachial plexus block: A randomized, double-blinded clinical trial
| Autor: | Fabiana Schuelter-Trevisol, Daisson José Trevisol, Thiago Mamôru Sakae, Patricia Marchioro |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Nausea Dexamethasone law.invention Arthroscopy 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial 030202 anesthesiology law medicine Humans Ropivacaine Prospective Studies Anesthetics Local Ultrasonography Interventional Aged Pain Measurement Brachial plexus block Bupivacaine Pain Postoperative Plexus Shoulder Joint business.industry Incidence Middle Aged Amides Brachial Plexus Block Surgery Anesthesiology and Pain Medicine Elective Surgical Procedures Anesthesia Postoperative Nausea and Vomiting Administration Intravenous Female medicine.symptom business Brachial plexus 030217 neurology & neurosurgery Adjuvants Anesthesia medicine.drug |
| Zdroj: | Journal of Clinical Anesthesia. 38:133-136 |
| ISSN: | 0952-8180 |
| DOI: | 10.1016/j.jclinane.2017.02.004 |
| Popis: | 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).Randomized clinical trial.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.The onset time and duration of sensory blocks were assessed. Secondary outcomes were pain scores (VAS) and postoperative vomiting and nausea (PONV).The duration of the motor and sensory block was extended in group Dpn compared with group Div and group C (P0.05). 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.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. |
| Databáze: | OpenAIRE |
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