A randomized comparison between intravenous and perineural dexamethasone for ultrasound-guided axillary block
Autor: | Roderick J. Finlayson, Aida Gordon, Julián Aliste, Worakamol Tiyaprasertkul, Prangmalee Leurcharusmee, De Q.H. Tran, Tom C.R.V. Van Zundert, Giuliano Michelagnoli, Chonticha Sriparkdee, Phatthanaphol Engsusophon, Dana Q. Tran |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Lidocaine Adolescent medicine.drug_class Dexamethasone law.invention Injections Upper Extremity 03 medical and health sciences Young Adult 0302 clinical medicine Randomized controlled trial Double-Blind Method 030202 anesthesiology law Anesthesiology Axillary block medicine Humans Anesthesia Brachial Plexus 030212 general & internal medicine Prospective Studies Anesthetics Local Prospective cohort study Ultrasonography Interventional Aged Bupivacaine Aged 80 and over Local anesthetic business.industry General Medicine Middle Aged Brachial Plexus Block Confidence interval Ultrasound guided Surgery Anesthesiology and Pain Medicine Administration Intravenous Female Radiology business medicine.drug Adjuvants Anesthesia |
Zdroj: | Canadian journal of anaesthesia = Journal canadien d'anesthesie. 64(1) |
ISSN: | 1496-8975 |
Popis: | This randomized double-blinded trial compared the effect of intravenous and perineural dexamethasone (8 mg) on the duration of motor block for ultrasound (US)-guided axillary brachial plexus block (AXB). Patients undergoing upper limb surgery with US-guided AXB were randomly allocated to receive preservative-free dexamethasone (8 mg) via intravenous (n = 75) or perineural (n = 75) administration. The local anesthetic agent, 1% lidocaine −0.25% bupivacaine (30 mL) with epinephrine 5 µg·mL−1, was identical in all subjects. Operators and patients were blinded to the nature of the intravenous and perineural injectate. A blinded observer assessed the block success rate (i.e., a minimal sensorimotor composite score of 14 out of 16 points at 30 min), block onset time, as well as the presence of surgical anesthesia. Postoperatively, the blinded observer contacted all patients with successful blocks to record the duration of motor block (primary outcome), sensory block, and postoperative analgesia. No intergroup differences were observed in terms of success rate, surgical anesthesia, and block onset time. Compared to intravenous administration, perineural dexamethasone provided longer mean (SD) durations for motor block [17.5 (4.6) hr vs 12.8 (4.5) hr; mean difference, 4.6 hr; 95% confidence interval [CI], −6.21 to −3.08; P |
Databáze: | OpenAIRE |
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