Thiago Mamoru Sakae
University of Southern Santa Catarina – UNISUL, Brazil
Title: Dexamethasone as a Ropivacaine Adjuvant for Ultrasound-guided Interscalene Brachial Plexus Block: A Randomized, Double-Blinded Clinical Trial
Biography
Biography: Thiago Mamoru Sakae
Abstract
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).
Methods: 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 20 ml of 0.75% ropivacaine with 1 ml of isotonic saline (C group, n = 20), 20 ml of 0.75% ropivacaine with 1 ml (4 mg) of perineural dexamethasone (Dpn group, n = 20), or 20 ml of 0.75% ropivacaine with 1 ml of isotonic saline and intravenous 4 mg 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).
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 24 h, 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 4 mg 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.