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Local anesthesia and dexamethasone

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https://www.readbyqxmd.com/read/28740419/perineural-versus-intravenous-dexamethasone-as-an-adjuvant-in-regional-anesthesia-a-systematic-review-and-meta-analysis
#1
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/28727704/evaluating-the-adjuvant-effect-of-dexamethasone-to-ropivacaine-in-transversus-abdominis-plane-block-for-inguinal-hernia-repair-and-spermatocelectomy-a-randomized-controlled-trial
#2
Robert Wegner, Duane Akwar, Sarah Guzman-Reyes, Greesha Pednekar, Rabail Chaudhry, Navneet Grewal, Naveen Kukreja, Omar L Mancillas, George W Williams, Omonele Nwokolo
BACKGROUND: The transversus abdominis plane (TAP) block is a relatively straightforward regional technique used for postoperative analgesia in patients undergoing abdominal surgeries. Various adjuvants have been used in past to prolong the duration of action of analgesia in peripheral nerve blocks. Several studies investigating the analgesic efficacy of dexamethasone added to local anesthetic agents, such as bupivacaine, have shown promising results. However, there are few studies comparing the efficacy of dexamethasone with ropivacaine...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28666096/a-comparative-study-on-the-efficacy-of-submucosal-injection-of-dexamethasone-versus-methylprednisolone-in-reducing-postoperative-sequelae-after-third-molar-surgery
#3
Daniel Lim, Wei Cheong Ngeow
PURPOSE: To compare the efficacy of preoperative submucosal injection of 4 mg of dexamethasone versus 40 mg of methylprednisolone in reducing postoperative sequelae after surgical removal of impacted mandibular third molars. PATIENTS AND METHODS: This prospective, randomized, double-blind study included 65 patients who required surgical removal of impacted mandibular third molars with Class II or position B impaction (Pell and Gregory classification). Patients were randomly assigned to 1 of 3 groups: dexamethasone, methylprednisolone, or placebo (control)...
June 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#4
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28578646/clonidine-but-not-dexamethasone-prolongs-ropivacaine-induced-supraclavicular-brachial-plexus-nerve-block-duration
#5
Dawood Nasir, Irina Gasanova, Shaina Drummond, John Alexander, Jo Howard, Emily Melikman, Gary Hill, Abu Minhajuddin, Babatunde Ogunnaike, Charles Whitten
BACKGROUND: Ultrasound-guided supraclavicular brachial plexus block (USSB) provides excellent postoperative analgesia after upper extremity surgery. Dexamethasone and clonidine have been added to local anesthetics to enhance and prolong the duration of analgesia. OBJECTIVE: The objective of this randomized prospective study is to evaluate the efficacy of dexamethasone, clonidine, or combination of both as adjuvants to ropivacaine on the duration of USSB for postoperative analgesia...
June 4, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28511890/intratympanic-steroid-delivery-by-an-indwelling-catheter-in-refractory-severe-sudden-sensorineural-hearing-loss
#6
Diego Zanetti, Federica Di Berardino, Nader Nassif, Luca Oscar Redaelli De Zinis
OBJECTIVE: Many studies over the last decade showed favorable outcomes with intratympanic (IT) steroid treatment, alone as salvage treatment or in combination with conventional systemic therapy (ST). However, in severe to profound sensorineural hearing loss resistant to ST, the optimal infusion mode, the type and concentration of the solution, the preferable drug, its total amount, and the duration and fractionation of the treatment are still debated. Aim of the study was to investigate the feasibility and the outcomes of a direct and constant IT delivery of dexamethasone (DEX) by means of a new indwelling catheter...
May 13, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28217067/septo-optic-dysplasia-de-morsier-s-syndrome
#7
Pedro Reis, Joana Mourão
Septo-optic dysplasia (SOD)/de Morsier's syndrome is characterized by optic nerve hypoplasia, pituitary endocrine dysfunction, and midline brain abnormalities. Hypopituitarism, hypothyroidism, hypogonadism, and adrenal insufficiency can lead to severe hypoglycemia, adrenal crisis, seizures, and sudden death. Anesthetic management of SOD was associated with high perioperative mortality. A 9-year-old male child proposed for dental treatments/extractions. Medical history of SOD with hypopituitarism, hypothyroidism, and delayed psychomotor development was observed...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28210917/adjuvant-agents-in-regional-anesthesia-in-the-ambulatory-setting
#8
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/28012528/the-effect-of-iv-dexamethasone-versus-local-anesthetic-infiltration-technique-in-postoperative-nausea-and-vomiting-after-tonsillectomy-in-children-a-randomized-double-blind-clinical-trial
#9
RANDOMIZED CONTROLLED TRIAL
Zoher Naja, Saleh Kanawati, Rania Al Khatib, Fouad Ziade, Zeina Z Naja, Ahmad Salah Naja, Mariam Rajab
BACKGROUND: Local anesthetic infiltration and corticosteroids had shown effectiveness in reducing post tonsillectomy nausea, vomiting and pain. OBJECTIVES: To compare the effect of intravenous dexamethasone versus pre-incision infiltration of local anesthesia in pediatric tonsillectomy on postoperative nausea and vomiting (PONV). The secondary objective was postoperative pain. METHODS: A randomized double-blind clinical trial was conducted at a tertiary care teaching hospital...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27833337/eventuality-of-dexamethasone-injected-intra-massetrically-on-post-operative-sequel-following-the-surgical-extraction-of-impacted-mandibular-third-molars-a-prospective-study
#10
G D Nandini
OBJECTIVE: The objective of the study was to compare the efficacy of dexamethasone given intra-massetrically via intra buccal approach on postoperative sequele after surgical extraction of impacted mandibular third molars. METHODOLOGY: Twenty patients, each of who required surgical extraction of a single impacted mandibular third molar under local anesthesia, were randomly set apart to one of the two groups of ten each. The experimental group received dexamethasone 8 mg injected to the masseter muscle intra buccally and the control group did not receive any steroid...
December 2016: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/27790253/effect-of-dexamethasone-intraligamentary-injection-on-post-endodontic-pain-in-patients-with-symptomatic-irreversible-pulpitis-a-randomized-controlled-clinical-trial
#11
Payman Mehrvarzfar, Ehsan Esnashari, Reyhaneh Salmanzadeh, Mahta Fazlyab, Mahyar Fazlyab
INTRODUCTION: The aim of this randomized-controlled clinical trial was to assess the effect of intraligamentary (PDL) injection of dexamethasone on onset and severity of post-treatment pain in patients with symptomatic irreversible pulpitis. METHODS AND MATERIALS: A total number of 60 volunteers were included according to the inclusion criteria and were assigned to three groups (n=20). After administration of local anesthesia and before treatment, group 1 (control) PDL injection was done with syringe containing empty cartridge, while in groups 2 and 3 the PDL injection was done with 0...
2016: Iranian Endodontic Journal
https://www.readbyqxmd.com/read/27755433/effect-of-oral-administration-of-bromelain-on-postoperative-discomfort-after-third-molar-surgery
#12
Paolo Ghensi, Alessandro Cucchi, Luca Creminelli, Cristiano Tomasi, Barbara Zavan, Carlo Maiorana
INTRODUCTION: The purpose of this prospective randomized controlled clinical trial was to evaluate the effect of oral administration of bromelain on discomfort after mandibular third molar surgery. MATERIALS AND METHODS: Eighty-four consecutive patients requiring surgical removal of a single mandibular impacted third molar under local anesthesia were randomly assigned to receiving no drug (control group, Group A), postoperative 40 mg bromelain every 6 hours for 6 days (Group B), preoperative 4 mg dexamethasone sodium phosphate as a submucosal injection (Group C), and preoperative 4 mg dexamethasone sodium phosphate as a submucosal injection plus postoperative 40 mg bromelain every 6 hours for 6 days (Group D)...
March 2017: Journal of Craniofacial Surgery
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
#13
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/27716229/particulate-steroid-betamethasone-added-to-ropivacaine-in-interscalene-brachial-plexus-block-for-arthroscopic-rotator-cuff-repair-improves-postoperative-analgesia
#14
Kunitaro Watanabe, Joho Tokumine, Tomoko Yorozu, Kumi Moriyama, Hideaki Sakamoto, Tetsuo Inoue
BACKGROUND: Dexamethasone added to local anesthetic for brachial plexus block improves postoperative pain after arthroscopic rotator cuff repair, as compared with the use of local anesthetic alone. Dexamethasone is present in non-particulate form in local anesthetic solution, while betamethasone is partially present in particulate form. The particulate betamethasone gradually decays and is expected to cause its longer-lasting effect. This study investigated the postoperative analgesic effect of betamethasone added to ropivacaine for brachial plexus block in patients who underwent arthroscopic rotator cuff repair...
October 4, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27663451/a-randomized-comparison-between-intravenous-and-perineural-dexamethasone-for-ultrasound-guided-axillary-block
#15
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/27662065/local-infiltration-of-analgesics-at-surgical-wound-to-reduce-postoperative-pain-after-laparotomy-in-rats
#16
COMPARATIVE STUDY
Jeffrey S Kroin, Jinyuan Li, Mario Moric, Brian W Birmingham, Kenneth J Tuman, Asokumar Buvanendran
BACKGROUND AND OBJECTIVES: There is an increasing use of local infiltration analgesia (LIA) to reduce postoperative pain. Despite widespread use of LIA, wide variations in drug combinations and concomitant use of systemic analgesics have made it difficult to determine the optimal drug combinations for LIA. Using a previously validated rat laparotomy model, the optimal LIA combination of medications to reduce postoperative pain was determined. METHODS: Laparotomy was performed in an adult rat model under isoflurane anesthesia...
November 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27283723/high-performance-liquid-chromatography-determination-of-dexamethasone-in-plasma-to-evaluate-its-systemic-absorption-following-intra-space-pterygomandibular-injection-of-twin-mix-mixture-of-2%C3%A2-lignocaine-with-1-200-000-epinephrine-and-4%C3%A2-mg-dexamethasone-randomized
#17
Darpan Bhargava, Ashwini Deshpande, Shaji Thomas, Yogesh Sharma, Piush Khare, Sanjeev Kumar Sahu, Suyash Dubey, Ankit Pandey, K Sreekumar
PURPOSE: To determine systemic absorption of dexamethasone by detection of plasma concentration using high performance liquid chromatography following its administration along with local anesthetic agent as a mixture via pterygomandibular space. METHODS: A prospective randomized double-blind clinical study was undertaken to analyze the plasma concentration of dexamethasone after intra-space pterygomandibular injection along with local anesthesia. The study was performed as per split mouth model where the mandibular quadrant allocation was done on a random basis considering each of the 30 patients is included in the two study interventions (SS and CS)...
September 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27195644/back-pain-and-neuraxial-anesthesia
#18
REVIEW
Honorio T Benzon, Yogen G Asher, Craig T Hartrick
The incidence of back pain after neuraxial anesthesia in the adult population is not different from that after general anesthesia. The pain is usually mild, localized in the low back, rarely radiates to the lower extremities, and has a duration of only a few days. The risk factors for development of back pain include the lithotomy position, multiple attempts at block placement, duration of surgery longer than 2.5 hours, body mass index ≥32 kg/m, and a history of back pain. However, there is no permanent worsening of preexisting back pain after neuraxial anesthesia...
June 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27192920/-the-diagnosis-and-treatment-of-one-huge-cystic-lymphangioma-in-etropharyngeal-space
#19
Hua Zhang, Xicheng Song, Chuanliang Jia
One child was hospitalized because of repeated cough and sputum. The biopsy diagnosis in local hospital was cystic lymphangioma in retropharyngeal space. We carried out transoral incision and drainage by catheter under general anesthesia. Put into the surgical cavity a suction drainage tube, and injected 5 mg dexamethasone and 8mg Bleomycin. He had nasogastric liquid diet after operation. We removed the suction drainage tube two weeks later. No recurrence was found following up over two years.
January 2016: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/27015546/a-multicenter-randomized-comparison-between-intravenous-and-perineural-dexamethasone-for-ultrasound-guided-infraclavicular-block
#20
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
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