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dexamethasone AND peripheral nerve block

Alexander D Cohen, Mark C Kendall
No abstract text is available yet for this article.
February 13, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
J D Turner, S W Dobson, R S Weller, G B Russell, D S Henshaw
BACKGROUND: Recent studies have concluded that i.v. dexamethasone can prolong the duration of peripheral nerve blockade. We hypothesized that a 4 mg dose would equally prolong the duration of psoas compartment blocks (PCBs) when compared with 8 mg, and that both doses would prolong the duration when compared with placebo. METHODS: This was a prospective, randomized, placebo-controlled, dose-dependent, equivalency trial with 115 patients undergoing total hip arthroplasty...
February 2018: British Journal of Anaesthesia
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
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...
January 26, 2018: Regional Anesthesia and Pain Medicine
Po-Ting Pan, I-Shiang Tzeng, Chun-Jen Huang
No abstract text is available yet for this article.
January 2018: Regional Anesthesia and Pain Medicine
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
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
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
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
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
Ashraf Elsayed Alzeftawy, Nabil Aly Elsheikh
BACKGROUND: Peripheral nerve blocks have become an increasingly popular form of anesthesia. Preemptive analgesia reduces central sensitization, postoperative pain, and analgesic consumption. Different additive has been used to prolong regional blockade and improve postoperative analgesia. AIM: This study was conducted to evaluate whether preemptive ankle block using combination of ropivacaine and dexamethasone would succeed in improving the postoperative analgesia after foot surgery in patients receiving general anesthesia...
April 2017: Anesthesia, Essays and Researches
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
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
Oya Y Cok, Sinan Deniz, H Evren Eker, Levent Oguzkurt, Anis Aribogan
Patients with isolated peripheral branch neuralgia of trigeminal nerve usually receive traditional treatment such as medical therapy and interventional procedures targeting the entire trigeminal nerve or related ganglions. However, if the intractable pain is limited to a certain branch, the patient may also benefit from a peripheral and nerve-targeted interventional approach. Here, we report the management of a patient with isolated infraorbital neuralgia by ultrasound-guided infraorbital nerve block with steroid and local anesthetic combination...
February 2017: Journal of Clinical Anesthesia
Jie Huang, Zhongge Ni, Philip Finch
OBJECTIVES: Varicella zoster virus reactivation can cause permanent histological changes in the central and peripheral nervous system. Neural inflammatory changes or damage to the dorsal root ganglia sensory nerve fibers during reactivation can lead to postherpetic neuralgia (PHN). For PHN of the first division of the fifth cranial nerve (ophthalmic division of the trigeminal ganglion), there is evidence of inflammatory change in the ganglion and adjacent ocular neural structures. First division trigeminal nerve PHN can prove to be difficult and sometimes even impossible to manage despite the use of a wide range of conservative measures, including anticonvulsant and antidepressant medication...
September 2017: Pain Practice: the Official Journal of World Institute of Pain
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
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
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
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...
November 2017: American Journal of Therapeutics
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
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