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Perineural dexamethasone

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https://www.readbyqxmd.com/read/28394848/a-new-step-toward-evidence-of-in-vivo-perineural-dexamethasone-safety-an-animal-study
#1
Philippe Marty, Mehdi Bennis, Benjamin Legaillard, Etienne Cavaignac, Fabrice Ferre, Julie Lebon, Anne Brouchet, Vincent Minville
BACKGROUND AND OBJECTIVES: The aim of this study was to analyze histological nerve toxicity of perineural dexamethasone administration in combination with ropivacaine on mice. Efficacy of perineural dexamethasone in combination with regional anesthesia is clearly demonstrated. However, the safety of this procedure is still a matter of debate. METHODS: A sciatic nerve block was performed on 90 mice. Five groups, each containing 18 mice assigned randomly, were used in these experiments: the sham group (isotonic saline solution), R group (perineural ropivacaine), D group (perineural dexamethasone), RDPN group (perineural ropivacaine and perineural dexamethasone), and the RDS group (perineural ropivacaine and systemic dexamethasone)...
April 7, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28372653/dexamethasone-as-a-ropivacaine-adjuvant-for-ultrasound-guided-interscalene-brachial-plexus-block-a-randomized-double-blinded-clinical-trial
#2
Thiago Mamôru Sakae, Patricia Marchioro, Fabiana Schuelter-Trevisol, Daisson José Trevisol
STUDY 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). DESIGN: 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 20ml of 0...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28371877/comprehensive-analysis-of-13-897-consecutive-regional-anesthetics-at-an-ambulatory-surgery-center
#3
Randall J Malchow, Rajnish K Gupta, Yaping Shi, Matthew S Shotwell, Lisa M Jaeger, Clifford Bowens
Objective.:  The authors investigated a wide range of perioperative outcome measures in the context of a robust regional anesthesia practice. Design.:  Comprehensive review of a prospectively collected six-year database. Setting.:  Freestanding, academic ambulatory surgery center. Subjects.:  There were 13,897 consecutive regional anesthetics in 10,338 patients. Methods.:  We investigated patient satisfaction, postoperative nausea and vomiting (PONV), postoperative pain, catheter analgesia, and complications...
March 24, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28252523/perineural-versus-intravenous-dexamethasone-as-an-adjuvant-for-peripheral-nerve-blocks-a-systematic-review-and-meta-analysis
#4
Matthew Alan Chong, Nicolas Matthew Berbenetz, Cheng Lin, Sudha Singh
BACKGROUND AND OBJECTIVES: Dexamethasone is a useful adjuvant in regional anesthesia that is used to prolong the duration of analgesia for peripheral nerve blocks. Recent randomized controlled trials (RCTs) have demonstrated conflicting results as to whether perineural versus intravenous (IV) administration is superior in this regard, and the perineural use of dexamethasone remains off-label. Therefore, we sought to perform a systematic review and meta-analysis of RCTs. METHODS: In accordance with PRISMA guidelines, we performed a random-effects meta-analysis of RCTs comparing perineural versus IV dexamethasone with duration of analgesia as the primary outcome...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28210917/adjuvant-agents-in-regional-anesthesia-in-the-ambulatory-setting
#5
REVIEW
Veerandra Koyyalamudi, Sudipta Sen, Shilpadevi Patil, Justin B Creel, Elyse M Cornett, Charles J Fox, Alan D Kaye
PURPOSE OF REVIEW: A majority of surgical practice has involved ambulatory centers with the number of outpatient operations in the USA doubling to 26.8 million per year. Local anesthesia delivery provides numerous benefits, including increased satisfaction, earlier discharge, and reduction in unplanned hospital admission. Further, with the epidemic of opioid mediated overdoses, local anesthesia can be a key tool in providing an opportunity to reduce the need for other analgesics postoperatively...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28033159/effect-of-perineural-dexamethasone-on-the-duration-of-single-injection-saphenous-nerve-block-for-analgesia-after-major-ankle-surgery-a-randomized-controlled-study
#6
Siska Bjørn, Frank Linde, Kristian K Nielsen, Jens Børglum, Rasmus Wulff Hauritz, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: Patients undergoing major elective ankle surgery often experience pain from the saphenous nerve territory persisting beyond the duration of a single-injection saphenous nerve block. We hypothesized that perineural dexamethasone as an adjuvant for the saphenous nerve block prolongs the duration of analgesia and postpones as well as reduces opioid-requiring pain. METHODS: Forty patients were included in this prospective, randomized, controlled study...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27799178/does-dexamethasone-have-a-perineural-mechanism-of-action-a-paired-blinded-randomized-controlled-study-in-healthy-volunteers
#7
P Jæger, U Grevstad, Z J Koscielniak-Nielsen, A R Sauter, J K Sørensen, J B Dahl
BACKGROUND: Dexamethasone prolongs block duration. Whether this is achieved via a peripheral or a central mechanism of action is unknown. We hypothesized that perineural dexamethasone added as an adjuvant to ropivacaine prolongs block duration compared with ropivacaine alone, by a locally mediated effect when controlled for a systemic action. METHODS: We performed a paired, blinded, randomized trial, including healthy men. All subjects received bilateral blocks of the saphenous nerve with ropivacaine 0...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#8
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 hours) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
January 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27733325/perineural-dexamethasone-does-not-enhance-the-analgesic-efficacy-of-ultrasound-guided-subcostal-transversus-abdominis-plane-block-during-laparoscopic-cholecystectomy
#9
RANDOMIZED CONTROLLED TRIAL
Sheng-Hui Huang, Jing Lu, Hong-Yun Gan, Yi Li, Yong-Gang Peng, Shuan-Ke Wang
BACKGROUND: Ultrasound-guided transversus abdominis plane (TAP) block is an adjunct therapy to provide effective postoperative analgesia in abdominal surgical procedures. Dexamethasone is a supplement agent that can improve the efficacy of local anesthesia. However, information about its additive effect is limited. This study aimed to compare the analgesic efficiency using ultrasound-guided TAP block with and without perineural dexamethasone for patients who underwent laparoscopic cholecystectomy...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27663451/a-randomized-comparison-between-intravenous-and-perineural-dexamethasone-for-ultrasound-guided-axillary-block
#10
RANDOMIZED CONTROLLED TRIAL
Julian Aliste, Prangmalee Leurcharusmee, Phatthanaphol Engsusophon, Aida Gordon, Giuliano Michelagnoli, Chonticha Sriparkdee, Worakamol Tiyaprasertkul, Dana Q Tran, Tom C R V Van Zundert, Roderick J Finlayson, De Q H Tran
BACKGROUND: 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). METHODS: 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...
January 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27473629/the-combination-of-iv-and-perineural-dexamethasone-prolongs-the-analgesic-duration-of-intercostal-nerve-blocks-compared-with-iv-dexamethasone-alone
#11
Dermot P Maher, Derek Serna-Gallegos, Rodney Mardirosian, Otto J Thomas, Xiao Zhang, Robert McKenna, Roya Yumul, Vida Zhang
OBJECTIVE:  The use of multiple-level, single-injection intercostal nerve blocks for pain control following video-assisted thorascopic surgery (VATS) is limited by the analgesic duration of local anesthetics. This study examines whether the combination of perineural and intravenous (IV) dexamethasone will prolong the duration of intraoperatively placed intercostal nerve blocks following VATS compared with IV dexamethasone and a perineural saline placebo. DESIGN:  Prospective, double-blind, randomized placebo-controlled trial...
July 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27372380/analgesic-effect-of-a-single-dose-of-perineural-dexamethasone-on-ultrasound-guided-femoral-nerve-block-after-total-knee-replacement
#12
C Morales-Muñoz, J L Sánchez-Ramos, M D Díaz-Lara, J González-González, I Gallego-Alonso, M S Hernández-Del-Castillo
INTRODUCTION: Total knee replacement is usually a very painful procedure. A single-dose of femoral nerve block has been shown to provide similar analgesia to an epidural, with fewer side effects, but limited in time. OBJECTIVE: To compare the analgesia provided by dexamethasone used at perineural level in the femoral nerve block after total knee replacement with the one used at intravenous level, and with that of a control group. MATERIAL AND METHODS: A prospective, randomised, double-blind controlled trial was conducted on 81 patients randomly assigned to one of three groups: 1)IV dexamethasone (8mg); 2)perineural dexamethasone (8mg), and 3)placebo...
January 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27281084/which-is-your-choice-for-prolonging-the-analgesic-duration-of-single-shot-interscalene-brachial-blocks-for-arthroscopic-shoulder-surgery-intravenous-dexamethasone-5%C3%A2-mg-vs-perineural-dexamethasone-5%C3%A2-mg-randomized-controlled-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
Eun Hee Chun, Youn Jin Kim, Jae Hee Woo
The aim of this study was to compare the effect of intravenous (I.V.) dexamethasone with that of perineural dexamethasone on the prolongation of analgesic duration of single-shot interscalene brachial plexus blocks (SISB) in patients undergoing arthroscopic shoulder surgery. We performed a prospective, randomized, double-blind, placebo-controlled study. Patients undergoing elective arthroscopic shoulder surgery with ultrasound-guided SISB were enrolled and randomized into 2 groups. A total volume of 12 mL of the study drug was prepared with a final concentration of 0...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27255560/dexamethasone-as-adjuvant-for-femoral-nerve-block-following-knee-arthroplasty-a-randomized-controlled-study
#14
COMMENT
A A Sherif, H E Elsersy
BACKGROUND: We examined the effect of the addition of dexamethasone to bupivacaine for femoral nerve blocks on the block duration and the quality of post-operative analgesia following total knee replacement surgery. METHODS: In total, 200 ASA I-III patients were randomly allocated to either the control group who received bupivacaine 0.5% or the dexamethasone group who received bupivacaine 0.5% plus 8 mg dexamethasone for the femoral nerve block, followed by a continuous perineural bupivacaine infusion started at the time of block resolution...
August 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27075893/perineural-dexamethasone-with-subsartorial-saphenous-nerve-blocks-in-acl-reconstruction
#15
Mary F Chisholm, Jennifer Cheng, Kara G Fields, Robert G Marx, Daniel B Maalouf, Gregory A Liguori, Michael A Gordon, Victor M Zayas, Jacques T Yadeau
PURPOSE: Subsartorial saphenous nerve blockade (SSNB) is an effective analgesic alternative to femoral nerve blockade after anterior cruciate ligament (ACL) reconstruction with bone-tendon-bone (BTB) autograft. It was hypothesized that dexamethasone in a SSNB will prolong analgesia, improve pain and satisfaction, and reduce postoperative opioid requirements and side effects. METHODS: One hundred ninety-five patients undergoing ACL reconstruction with BTB autograft (ages 16-65) were enrolled...
April 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27015546/a-multicenter-randomized-comparison-between-intravenous-and-perineural-dexamethasone-for-ultrasound-guided-infraclavicular-block
#16
RANDOMIZED CONTROLLED TRIAL
Prangmalee Leurcharusmee, Julian Aliste, Tom C R V Van Zundert, Phatthanaphol Engsusophon, Vanlapa Arnuntasupakul, Worakamol Tiyaprasertkul, Amornrat Tangjitbampenbun, Sonia Ah-Kye, Roderick J Finlayson, De Q H Tran
BACKGROUND AND OBJECTIVES: This multicenter, randomized trial compared intravenous (IV) and perineural (PN) dexamethasone for ultrasound (US)-guided infraclavicular brachial plexus block. Our research hypothesis was both modalities would result in similar durations of motor block. METHODS: One hundred fifty patients undergoing upper limb surgery with US-guided infraclavicular block were randomly allocated to receive IV or PN dexamethasone (5 mg). The local anesthetic agent (35 mL of lidocaine 1%-bupivacaine 0...
May 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26952122/-glucocorticoids-as-an-adjunct-in-peripheral-regional-anesthesia-move-to-the-holy-grail-of-perineural-analgesia
#17
REVIEW
T Wiesmann, T Volk, T Steinfeldt
BACKGROUND: The role of dexamethasone as an adjunct in peripheral nerve blockades is still unclear. OBJECTIVES: This article reviews the actual knowledge and scientific evidence for dexamethasone as an adjunct in peripheral regional anesthesia. Moreover, it discusses the benefits of the systemic versus the perineural mode of application. RESULTS: Dexamethasone prolongs sensible as well as motor blockades in peripheral nerve blocks when applied intravenously or perineurally...
April 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/26938764/effect-of-perineural-dexamethasone-with-bupivacaine-in-single-space-paravertebral-block-for-postoperative-analgesia-in-elective-nephrectomy-cases-a-double-blind-placebo-controlled-trial
#18
Gaurav Singh Tomar, Suprio Ganguly, Grace Cherian
Various analgesic modalities have been tried to prolong the duration and to improve the quality of postoperative analgesia for the early rehabilitation and discharge from hospital after nephrectomy. Using local anaesthetic along with perineural steroids as adjuvant may prove promising for peripheral nerve block, especially paravertebral block (PVB). This article aims to assess the efficacy of dexamethasone with bupivacaine as adjuvant for single bolus injection of thoracic PVB in patients undergoing elective nephrectomy...
January 27, 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/26899862/perineural-versus-intravenous-dexamethasone-as-adjuncts-to-local-anaesthetic-brachial-plexus-block-for-shoulder-surgery
#19
RANDOMIZED CONTROLLED TRIAL
D M Rosenfeld, M G Ivancic, S J Hattrup, K J Renfree, A R Watkins, J G Hentz, A W Gorlin, J A Spiro, T L Trentman
This randomised, double-blind, placebo-controlled study compared the effect of perineural with intravenous dexamethasone, both administered concomitantly with interscalene brachial plexus block for shoulder surgery. Patients received 8 mg dexamethasone mixed with ropivacaine in the block injection (n = 42), 8 mg dexamethasone intravenously at the time of the block (n = 37), or intravenous saline (n = 41) at the time of the block. Perineural and intravenous dexamethasone resulted in prolonged mean (SD) duration of block to 16...
April 2016: Anaesthesia
https://www.readbyqxmd.com/read/26814246/buprenorphine-clonidine-dexamethasone-and-ropivacaine-for-interscalene-nerve-blockade-a-prospective-randomized-blinded-ropivacaine-dose-response-study
#20
RANDOMIZED CONTROLLED TRIAL
Jacques T YaDeau, Michael A Gordon, Enrique A Goytizolo, Yi Lin, Kara G Fields, Amanda K Goon, Guilherme Holck, Timothy W Miu, Lawrence V Gulotta, David M Dines, Edward V Craig
OBJECTIVE: This study investigated interscalene block for shoulder arthroplasty with various ropivacaine concentrations in the presence of clonidine, dexamethasone, and buprenorphine. The goal was prolonged analgesia with minimal motor blockade. DESIGN: Prospective, double-blind, randomized controlled trial. SETTING: University-affiliated orthopedic hospital. METHODS: Patients (20/group) received acetaminophen, ketorolac, pregabalin, opioids, and "Control"; interscalene block, 0...
May 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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