Perineural dexamethasone successfully prolongs adductor canal block when assessed by objective pinprick sensory testing: A prospective, randomized, dose-dependent, placebo-controlled equivalency trial

Journal of Clinical Anesthesia
James D TurnerSean W Dobson

Abstract

To determine whether perineural dexamethasone prolongs peripheral nerve blockade (PNB) when measured objectively; and to determine if a 1 mg and 4 mg dose provide equivalent PNB prolongation compared to PNB without dexamethasone. Multiple studies have reported that perineural dexamethasone added to local anesthetics (LA) can prolong PNB. However, these studies have relied on subjective end-points to quantify PNB duration. The optimal dose remains unknown. We hypothesized that 1 mg of perineural dexamethasone would be equivalent in prolonging an adductor canal block (ACB) when compared to 4 mg of dexamethasone, and that both doses would be superior to an ACB performed without dexamethasone. This was a prospective, randomized, double-blind, placebo-controlled equivalency trial involving 85 patients undergoing a unicompartmental knee arthroplasty. All patients received an ACB with 20 ml of 0.25% bupivacaine with 1:400,000 epinephrine. Twelve patients had 0 mg of dexamethasone (placebo) added to the LA mixture; 36 patients had 1 mg of dexamethasone in the LA; and 37 patients had 4 mg of dexamethasone in the LA. The primary outcome was block duration determined by serial neurologic pinprick examinations. Secondary outcomes included ...Continue Reading

Associated Clinical Trials

References

Mar 11, 2010·Regional Anesthesia and Pain Medicine·Jennifer D KirkpatrickJohn G Antonakakis
Feb 19, 2014·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Neil S BailardRoland A Flores
May 2, 2014·Anesthesia and Analgesia·Brian A WilliamsJames W Ibinson
Mar 26, 2016·Regional Anesthesia and Pain Medicine·Prangmalee LeurcharusmeeDe Q H Tran
Sep 25, 2016·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Julian AlisteDe Q H Tran

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