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Perineural dexamethasone

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https://www.readbyqxmd.com/read/29753264/perineural-dexamethasone-successfully-prolongs-adductor-canal-block-when-assessed-by-objective-pinprick-sensory-testing-a-prospective-randomized-dose-dependent-placebo-controlled-equivalency-trial
#1
James D Turner, Daryl S Henshaw, Robert S Weller, J Douglas Jaffe, Christopher J Edwards, J Wells Reynolds, Gregory B Russell, Sean W Dobson
STUDY OBJECTIVE: 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. SETTING: 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...
May 8, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29661400/corrigendum-to-perineural-dexamethasone-the-dilemma-of-systematic-reviews-and-meta-analyses-br-j-anaesth-2018-120-201-203
#2
P Marhofer, M Columb, P M Hopkins
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29630032/perineural-versus-systemic-dexamethasone-in-front-foot-surgery-under-ankle-block-a-randomized-double-blind-study
#3
Philippe Marty, Olivier Rontes, Clément Chassery, Corine Vuillaume, Bertrand Basset, Mehdi Merouani, Constance Marquis, Benoit Bataille, Martine Chaubard, Marie Claude Mailles, Fabrice Ferré, Alain Delbos
BACKGROUND AND OBJECTIVES: Among the different adjuvants, dexamethasone is one of the most accepted to prolong the effect of local anesthetics. This study aims to determine the superiority of perineural over systemic dexamethasone administration after a single-shot ankle block in metatarsal osteotomy. METHODS: We performed a prospective, double-blind, randomized study. A total of 100 patients presenting for metatarsal osteotomy with an ankle block were randomized into 2 groups: 30 mL ropivacaine 0...
April 6, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29628577/comparison-of-dexamethasone-and-buprenorphine-as-adjuvant-in-ultrasound-guided-brachial-plexus-blocks-a-randomized-controlled-trial
#4
Prasanna Vadhanan, Narendren Ganesh, M I Hussain Ahmed
Introduction: Effective postoperative analgesia is imperative for orthopedic surgeries to enhance recovery and facilitate early ambulation. Various additives have been used as adjuvants with local anesthetics in peripheral nerve blocks to provide postoperative analgesia. The aim of this study is to compare the duration of postoperative analgesia with buprenorphine and dexamethasone when administered as an adjuvant during ultrasound-guided brachial plexus blocks. Methodology: Sixty adult patients undergoing various upper arm surgeries were recruited for the study after acquiring ethics committee clearance...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29406171/co-administration-of-dexamethasone-with-peripheral-nerve-block-intravenous-vs-perineural-application-systematic-review-meta-analysis-meta-regression-and-trial-sequential-analysis
#5
REVIEW
M Heesen, M Klimek, G Imberger, S E Hoeks, R Rossaint, S Straube
BACKGROUND: I.V. and perineural dexamethasone have both been found to prolong loco-regional analgesia compared with controls without dexamethasone. It is unclear whether perineural administration offers advantages when compared with i.v. dexamethasone. METHODS: A systematic literature search was performed to identify randomized controlled double-blind trials that compared i.v. with perineural dexamethasone in patients undergoing surgery. Using the random effects model, risk ratio (for binary variables), weighted mean difference (for continuous variables) and 95% confidence intervals were calculated...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29406166/perineural-dexamethasone-the-dilemma-of-systematic-reviews-and-meta-analyses
#6
EDITORIAL
P Marhofer, M Columb, P M Hopkins
No abstract text is available yet for this article.
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29377866/dexamethasone-as-an-adjuvant-to-femoral-nerve-block-in-children-and-adolescents-undergoing-knee-arthroscopy-a-prospective-randomized-double-blind-placebo-controlled-trial
#7
Giorgio Veneziano, David P Martin, Ralph Beltran, NʼDiris Barry, Dmitry Tumin, Candice Burrier, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND AND OBJECTIVES: Perineural dexamethasone has been demonstrated to extend postsurgical analgesia after peripheral nerve blockade in adults. The mechanism of action of dexamethasone as a regional anesthetic adjuvant is unclear as intravenous dexamethasone has been shown to have similar analgesic efficacy as perineural dexamethasone. The efficacy of perineural dexamethasone has not been previously explored in the pediatric population. METHODS: After obtaining informed consent, children (aged 10-18 years) presenting for arthroscopic knee surgery with a femoral nerve block were randomized to 1 of 3 groups: ropivacaine 0...
May 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29180895/postoperative-pain-management-in-the-postanesthesia-care-unit-an-update
#8
REVIEW
Jie Luo, Su Min
Acute postoperative pain remains a major problem, resulting in multiple undesirable outcomes if inadequately controlled. Most surgical patients spend their immediate postoperative period in the postanesthesia care unit (PACU), where pain management, being unsatisfactory and requiring improvements, affects further recovery. Recent studies on postoperative pain management in the PACU were reviewed for the advances in assessments and treatments. More objective assessments of pain being independent of patients' participation may be potentially appropriate in the PACU, including photoplethysmography-derived parameters, analgesia nociception index, skin conductance, and pupillometry, although further studies are needed to confirm their utilities...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29164528/equivalent-analgesic-effectiveness-between-perineural-and-intravenous-dexamethasone-as-adjuvants-for-peripheral-nerve-blockade-a-systematic-review-and-meta-analysis
#9
REVIEW
Nasir Hussain, Tom Van den Langenbergh, Corey Sermer, Manuel L Fontes, Amit Atrey, Naum Shaparin, Tamara R Sawyer, Amaresh Vydyanathan
PURPOSE: Dexamethasone is commonly used as an adjuvant to local anesthetics for peripheral nerve blockade; however, uncertainty persists regarding its optimal route of administration and safety. A systematic review and meta-analysis of randomized-controlled trials (RCTs) was conducted to compare the incremental benefits of intravenous (IV) vs perineural (PN) dexamethasone when used as adjuvants for peripheral nerve blockade to improve analgesia. SOURCES: A search strategy was developed to identify eligible articles from the Cochrane and National Library of Medicine databases from inception until June 2017...
February 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29127558/effect-of-dexamethasone-dose-and-route-on-the-duration-of-interscalene-brachial-plexus-block-for-outpatient-arthroscopic-shoulder-surgery-a-randomized-controlled-trial
#10
Darren Holland, Ryan J J Amadeo, Scott Wolfe, Linda Girling, Faylene Funk, Mark Collister, Emily Czaplinski, Celeste Ferguson, Jeff Leiter, Jason Old, Peter MacDonald, Brenden Dufault, Thomas C Mutter
PURPOSE: Dexamethasone prolongs the duration of interscalene block, but the benefits of higher doses and perineural vs intravenous administration remain unclear. METHODS: This factorial design, double-blinded trial randomized 280 adult patients undergoing ambulatory arthroscopic shoulder surgery at a single centre in a 1:1:1:1 ratio. Patients received ultrasound-guided interscalene block with 30 mL 0.5% bupivacaine and 4 mg or 8 mg dexamethasone by either the perineural or intravenous route...
January 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29121400/dexamethasone-as-an-adjuvant-to-peripheral-nerve-block
#11
REVIEW
Carolyne Pehora, Annabel Me Pearson, Alka Kaushal, Mark W Crawford, Bradley Johnston
BACKGROUND: Peripheral nerve block (infiltration of local anaesthetic around a nerve) is used for anaesthesia or analgesia. A limitation to its use for postoperative analgesia is that the analgesic effect lasts only a few hours, after which moderate to severe pain at the surgical site may result in the need for alternative analgesic therapy. Several adjuvants have been used to prolong the analgesic duration of peripheral nerve block, including perineural or intravenous dexamethasone. OBJECTIVES: To evaluate the comparative efficacy and safety of perineural dexamethasone versus placebo, intravenous dexamethasone versus placebo, and perineural dexamethasone versus intravenous dexamethasone when added to peripheral nerve block for postoperative pain control in people undergoing surgery...
November 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29043004/efficacy-of-perineural-dexamethasone-with-ropivacaine-in-adductor-canal-block-for-post-operative-analgesia-in-patients-undergoing-total-knee-arthroplasty-a-randomized-controlled-trial
#12
Cun-Jin Wang, Feng-Yun Long, Liu-Qing Yang, You-Jing Shen, Fang Guo, Tian-Feng Huang, Ju Gao
Adductor canal block (ACB) is an effective analgesic alternative to femoral nerve block after total knee arthroplasty (TKA). The aim of the present study was to investigate whether addition of dexamethasone to ropivacaine for ACB is able to prolong analgesia and reduce pain. Study participants were randomized into groups receiving ACB with either 0.5% ropivacaine + normal saline (control group; n=93) or 0.5% ropivacaine + 8 mg dexamethasone (dexamethasone group; n=93). All patients were subjected to identical peri-operative management...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29036728/a-retrospective-study-evaluating-the-effect-of-low-doses-of-perineural-dexamethasone-on-ropivacaine-brachial-plexus-peripheral-nerve-block-analgesic-duration
#13
Gregory D Schnepper, Benjamin I Kightlinger, Yunyun Jiang, Bethany J Wolf, Eric D Bolin, Sylvia H Wilson
Objective: Examination of the effectiveness of perineural dexamethasone administered in very low and low doses on ropivacaine brachial plexus block duration. Design: Retrospective evaluation of brachial plexus block duration in a large cohort of patients receiving peripheral nerve blocks with and without perineural dexamethasone in a prospectively collected quality assurance database. Setting: A single academic medical center. Methods: A total of 1,942 brachial plexus blocks placed over a 16-month period were reviewed...
September 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28922230/optimal-dose-of-perineural-dexamethasone-to-prolong-analgesia-after-brachial-plexus-blockade-a-systematic-review-and-meta-analysis
#14
REVIEW
Kyle Robert Kirkham, Alain Jacot-Guillarmod, Eric Albrecht
BACKGROUND: Perineural dexamethasone has gained popularity in regional anesthesia to prolong analgesia duration. However, uncertainty remains regarding the optimal perineural dose. Clarification of this characteristic is of significant importance as the administration of dexamethasone may lead to dose-dependent complications. The objective of this meta-analysis was to define the optimal perineural dexamethasone dose to prolong analgesia after brachial plexus blockade for adult patients undergoing upper limb surgery...
January 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28854551/efficacy-of-perineural-vs-systemic-dexamethasone-to-prolong-analgesia-after-peripheral-nerve-block-a-systematic-review-and-meta-analysis
#15
M Baeriswyl, K R Kirkham, A Jacot-Guillarmod, E Albrecht
Perineural dexamethasone has gained popularity in regional anaesthesia to prolong the duration of analgesia, but its advantage over systemic administration is disputed. The objective of this meta-analysis was to compare the analgesic efficacy of both routes of administration during peripheral nerve block. The methodology followed the PRISMA statement guidelines. The primary outcome was the duration of analgesia analysed according to the type of local anaesthetic administered (bupivacaine or ropivacaine). Secondary outcomes included cumulative opioid consumption in morphine i...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28740419/perineural-versus-intravenous-dexamethasone-as-an-adjuvant-in-regional-anesthesia-a-systematic-review-and-meta-analysis
#16
REVIEW
Wen-Ling Zhao, Xiao-Feng Ou, Jin Liu, Wen-Sheng Zhang
BACKGROUND: Dexamethasone is a common adjuvant for local anesthetics in regional anesthesia, but the optimal route of administration is controversial. Therefore, we did a systematic review and meta-analysis of randomized controlled trials to assess the effect of perineural versus intravenous dexamethasone on local anesthetic regional nerve-blockade outcomes. MATERIALS AND METHODS: Medline (through PubMed), Embase, Cochrane, Web of Science, and Biosis Previews databases were systematically searched (published from inception of each database to January 1, 2017) to identify randomized controlled trials...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28591086/dexamethasone-injected-perineurally-is-more-effective-than-administered-intravenously-for-peripheral-nerve-blocks-a-meta-analysis-of-randomized-controlled-trials
#17
Andres Zorrilla-Vaca, Jinlei Li
INTRODUCTION: Peripheral nerve blocks (PNBs) are widely and increasingly used for better acute perioperative pain control for a variety of procedures. Clinically preservative-free dexamethasone is arguably the most commonly used adjuvant and offers the most optimization effects on PNBs yet with the least side-effects noted. Our aim was to compare the effectiveness of intravenous versus perineural dexamethasone on the effectiveness and safety of PNBs. METHODS: Major databases (PubMed, EMBASE, Cochrane library, ISI Web of Science, Google Scholar) were systematically searched for randomized controlled trials comparing the effectiveness of intravenous versus perineural dexamethasone on PNBs...
March 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28394848/a-new-step-toward-evidence-of-in-vivo-perineural-dexamethasone-safety-an-animal-study
#18
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)...
February 2018: 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
#19
RANDOMIZED CONTROLLED TRIAL
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
#20
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...
February 1, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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