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Perineural dexamethasone

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https://www.readbyqxmd.com/read/27799178/does-dexamethasone-have-a-perineural-mechanism-of-action-a-paired-blinded-randomized-controlled-study-in-healthy-volunteers
#1
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
#2
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 h) 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)...
October 28, 2016: 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
#3
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
#4
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...
September 23, 2016: 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
#5
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
#6
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...
June 29, 2016: 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
#7
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
#8
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
#9
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 13, 2016: 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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/26803223/new-modalities-of-pain-treatment-after-outpatient-orthopaedic-surgery
#15
REVIEW
M Beaussier, D Sciard, A Sautet
Postoperative pain relief is one of the cornerstones of success of orthopaedic surgery. Development of new minimally-invasive surgical procedures, as well as improvements in pharmacological and local and regional techniques should result in optimal postoperative pain control for all patients. The analgesic strategy has to be efficient, with minimal side effects, and be easy to manage at home. Multimodal analgesia allows for a reduction of opiate use and thereby its side effects. Local and regional analgesia is a major component of this multimodal strategy, associated with optimal pain relief, even upon mobilization, and it has beneficial effects on postoperative recovery...
February 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/26682721/a-randomised-controlled-trial-of-perineural-vs-intravenous-dexamethasone-for-foot-surgery
#16
RANDOMIZED CONTROLLED TRIAL
R L Dawson, D H McLeod, J P Koerber, J L Plummer, G C Dracopoulos
We used 20 ml ropivacaine 0.75% for ankle blocks before foot surgery in 90 participants who we allocated in equal numbers to: perineural dexamethasone 8 mg and intravenous saline 0.9%; perineural saline 0.9% and intravenous dexamethasone 8 mg; or perineural and intravenous saline 0.9%. Dexamethasone increased the median (IQR [range]) time for the return of some sensation or movement, from 14.6 (10.8-18.8 [5.5-38.0]) h with saline to 24.1 (19.3-29.3 [5.0-44.0]) h when given perineurally, p = 0.00098, and to 20...
March 2016: Anaesthesia
https://www.readbyqxmd.com/read/26355598/local-anesthetic-peripheral-nerve-block-adjuvants-for-prolongation-of-analgesia-a-systematic-qualitative-review
#17
Meghan A Kirksey, Stephen C Haskins, Jennifer Cheng, Spencer S Liu
BACKGROUND: The use of peripheral nerve blocks for anesthesia and postoperative analgesia has increased significantly in recent years. Adjuvants are frequently added to local anesthetics to prolong analgesia following peripheral nerve blockade. Numerous randomized controlled trials and meta-analyses have examined the pros and cons of the use of various individual adjuvants. OBJECTIVES: To systematically review adjuvant-related randomized controlled trials and meta-analyses and provide clinical recommendations for the use of adjuvants in peripheral nerve blocks...
2015: PloS One
https://www.readbyqxmd.com/read/26207854/neurotoxicity-of-common-peripheral-nerve-block-adjuvants
#18
REVIEW
Joshua B Knight, Nicholas J Schott, Michael L Kentor, Brian A Williams
PURPOSE OF REVIEW: This review outlines the analgesic role of perineural adjuvants for local anesthetic nerve block injections, and evaluates current knowledge regarding whether adjuvants modulate the neurocytologic properties of local anesthetics. RECENT FINDINGS: Perineural adjuvant medications such as dexmedetomidine, clonidine, buprenorphine, dexamethasone, and midazolam play unique analgesic roles. The dosing of these medications to prevent neurotoxicity is characterized in various cellular and in-vivo models...
October 2015: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/25974277/addition-of-dexamethasone-and-buprenorphine-to-bupivacaine-sciatic-nerve-block-a-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Jacques T YaDeau, Leonardo Paroli, Kara G Fields, Richard L Kahn, Vincent R LaSala, Kethy M Jules-Elysee, David H Kim, Stephen C Haskins, Jacob Hedden, Amanda Goon, Matthew M Roberts, David S Levine
BACKGROUND AND OBJECTIVES: Sciatic nerve block provides analgesia after foot and ankle surgery, but block duration may be insufficient. We hypothesized that perineural dexamethasone and buprenorphine would reduce pain scores at 24 hours. METHODS: Ninety patients received ultrasound-guided sciatic (25 mL 0.25% bupivacaine) and adductor canal (10 mL 0.25% bupivacaine) blockade, with random assignment into 3 groups (30 patients per group): control blocks + intravenous (IV) dexamethasone (4 mg) (control); control blocks + IV buprenorphine (150 μg) + IV dexamethasone (IV buprenorphine); and nerve blocks containing buprenorphine + dexamethasone (perineural)...
July 2015: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/25886227/comparative-evaluation-of-ropivacaine-and-ropivacaine-with-dexamethasone-in-supraclavicular-brachial-plexus-block-for-postoperative-analgesia
#20
Santosh Kumar, Urmila Palaria, Ajay K Sinha, D C Punera, Vijita Pandey
BACKGROUND: Mixing of various adjuvants has been tried with local anesthetics in an attempt to prolong anesthesia from peripheral nerve blocks but have met with inconclusive success. More recent studies indicate that 8 mg dexamethasone added to perineural local anesthetic injections augment the duration of peripheral nerve block analgesia. AIMS: Evaluating the hypothesis that adding dexamethasone to ropivacaine significantly prolongs the duration of analgesia in supraclavicular brachial plexus block compared with ropivacaine alone...
May 2014: Anesthesia, Essays and Researches
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