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dexamethasone AND peripheral nerve block

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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/26952122/-glucocorticoids-as-an-adjunct-in-peripheral-regional-anesthesia-move-to-the-holy-grail-of-perineural-analgesia
#3
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
#4
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/26803223/new-modalities-of-pain-treatment-after-outpatient-orthopaedic-surgery
#5
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/26355598/local-anesthetic-peripheral-nerve-block-adjuvants-for-prolongation-of-analgesia-a-systematic-qualitative-review
#6
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
#7
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/25886227/comparative-evaluation-of-ropivacaine-and-ropivacaine-with-dexamethasone-in-supraclavicular-brachial-plexus-block-for-postoperative-analgesia
#8
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
https://www.readbyqxmd.com/read/25856078/dexamethasone-as-adjuvant-to-bupivacaine-prolongs-the-duration-of-thermal-antinociception-and-prevents-bupivacaine-induced-rebound-hyperalgesia-via-regional-mechanism-in-a-mouse-sciatic-nerve-block-model
#9
Ke An, Nabil M Elkassabany, Jiabin Liu
BACKGROUND: Dexamethasone has been studied as an effective adjuvant to prolong the analgesia duration of local anesthetics in peripheral nerve block. However, the route of action for dexamethasone and its potential neurotoxicity are still unclear. METHODS: A mouse sciatic nerve block model was used. The sciatic nerve was injected with 60ul of combinations of various medications, including dexamethasone and/or bupivacaine. Neurobehavioral changes were observed for 2 days prior to injection, and then continuously for up to 7 days after injection...
2015: PloS One
https://www.readbyqxmd.com/read/25838589/interscalene-brachial-plexus-block-for-shoulder-arthroscopic-surgery-prospective-randomised-controlled-study-of-effects-of-0-5-ropivacaine-and-0-5-ropivacaine-with-dexamethasone
#10
Ashok Jadon, Shreya Dixit, Sunil Kr Kedia, Swastika Chakraborty, Amit Agrawal, Neelam Sinha
BACKGROUND AND AIMS: Various adjuvants have been used to prolong the duration of local anaesthetic action after peripheral and regional nerve blocks. We evaluated the effect of dexamethasone on the duration of pain relief in shoulder arthroscopic surgeries performed under interscalene brachial plexus using ropivacaine as local anaesthetic. METHODS: After Ethical Committee approval and informed consent from patients we performed a prospective, randomised, comparative study on patients scheduled for arthroscopic shoulder surgery under interscalene block (ISB)...
March 2015: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/25774458/combination-of-dexamethasone-and-local-anaesthetic-solution-in-peripheral-nerve-blocks-a-meta-analysis-of-randomised-controlled-trials
#11
REVIEW
Thi Mum Huynh, Emmanuel Marret, Francis Bonnet
BACKGROUND: Dexamethasone decreases postoperative pain and prolongs the duration of local anaesthetic peripheral nerve blocks in studies including a limited number of patients. OBJECTIVE: The objective of this study is to evaluate the effect of combining dexamethasone with local anaesthetic on sensory and motor peripheral nerve blockade in adults. DESIGN: A systematic review with meta-analysis of randomised controlled trials. DATA SOURCES: We systematically searched in Medline, Embase, Google Scholar and Cochrane Controlled Trials Register up to December 2013...
November 2015: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/25644836/nerve-block-for-the-treatment-of-headaches-and-cranial-neuralgias-a-practical-approach
#12
REVIEW
Fabíola Dach, Álan L Éckeli, Karen Dos S Ferreira, José G Speciali
BACKGROUND: Several studies have presented evidence that blocking peripheral nerves is effective for the treatment of some headaches and cranial neuralgias, resulting in reduction of the frequency, intensity, and duration of pain. OBJECTIVES: In this article we describe the role of nerve block in the treatment of headaches and cranial neuralgias, and the experience of a tertiary headache center regarding this issue. We also report the anatomical landmarks, techniques, materials used, contraindications, and side effects of peripheral nerve block, as well as the mechanisms of action of lidocaine and dexamethasone...
February 2015: Headache
https://www.readbyqxmd.com/read/25629321/intravenous-dexamethasone-and-perineural-dexamethasone-similarly-prolong-the-duration-of-analgesia-after-supraclavicular-brachial-plexus-block-a-randomized-triple-arm-double-blind-placebo-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Faraj W Abdallah, James Johnson, Vincent Chan, Harry Murgatroyd, Mohammad Ghafari, Noam Ami, Rongyu Jin, Richard Brull
BACKGROUND AND OBJECTIVES: Perineural dexamethasone prolongs the duration of single-injection peripheral nerve block when added to the local anesthetic solution. Postulated systemic mechanisms of action along with theoretical safety concerns have prompted the investigation of intravenous dexamethasone as an alternative, with decidedly mixed results. We aimed to confirm that addition of intravenous dexamethasone will prolong the duration of analgesia after single-injection supraclavicular block compared with conventional long-acting local anesthetic alone or in combination with perineural dexamethasone for ambulatory upper extremity surgery...
March 2015: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/25485150/perineural-dexamethasone-to-improve-postoperative-analgesia-with-peripheral-nerve-blocks-a-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Gildasio S De Oliveira, Lucas J Castro Alves, Autoun Nader, Mark C Kendall, Rohit Rahangdale, Robert J McCarthy
Background. The overall effect of perineural dexamethasone on postoperative analgesia outcomes has yet to be quantified. The main objective of this quantitative review was to evaluate the effect of perineural dexamethasone as a nerve block adjunct on postoperative analgesia outcomes. Methods. A systematic search was performed to identify randomized controlled trials that evaluated the effects of perineural dexamethasone as a block adjunct on postoperative pain outcomes in patients receiving regional anesthesia...
2014: Pain Research and Treatment
https://www.readbyqxmd.com/read/25351887/clinical-benchmarks-regarding-multimodal-peripheral-nerve-blocks-for-postoperative-analgesia-observations-regarding-combined-perineural-midazolam-clonidine-buprenorphine-dexamethasone
#15
Brian A Williams, James W Ibinson, Michael P Mangione, Rick L Scanlan, Peter Z Cohen
No abstract text is available yet for this article.
January 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/25123271/a-systematic-review-and-meta-analysis-of-perineural-dexamethasone-for-peripheral-nerve-blocks
#16
REVIEW
E Albrecht, C Kern, K R Kirkham
We systematically reviewed the safety and efficacy of perineural dexamethasone as an adjunct for peripheral nerve blockade in 29 controlled trials of 1695 participants. We grouped trials by the duration of local anaesthetic action (short- or medium- vs long-term). Dexamethasone increased the mean (95% CI) duration of analgesia by 233 (172-295) min when injected with short- or medium-term action local anaesthetics and by 488 (419-557) min when injected with long-term action local anaesthetics, p < 0.00001 for both...
January 2015: Anaesthesia
https://www.readbyqxmd.com/read/24954920/pain-management-for-elective-foot-and-ankle-surgery-a-systematic-review-of-randomized-controlled-trials
#17
REVIEW
Jia Wang, George T Liu, Helen G Mayo, Girish P Joshi
Pain after foot and ankle surgery can significantly affect the postoperative outcomes. We performed a systematic review of randomized controlled trials assessing postoperative pain after foot and ankle surgery, because the surgery will lead to moderate-to-severe postoperative pain, but the optimal pain therapy has been controversial. A systematic review of randomized controlled trials in English reporting on pain after foot and ankle surgery in adults published from January 1946 to February 2013 was performed...
July 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/24907282/dexamethasone-and-peripheral-nerve-blocks-on-the-nerve-or-intravenous
#18
EDITORIAL
V Martinez, D Fletcher
No abstract text is available yet for this article.
September 2014: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/24827696/comparison-of-peripheral-nerve-block-with-periarticular-injection-analgesia-after-total-knee-arthroplasty-a-randomized-controlled-study
#19
RANDOMIZED CONTROLLED TRIAL
Kazuhide Uesugi, Naoko Kitano, Tadashi Kikuchi, Miho Sekiguchi, Shin-Ichi Konno
BACKGROUND: Pain after total knee arthroplasty (TKA) is usually severe. Recently, the usefulness of local periarticular injection analgesia (PAI) and peripheral nerve block (PNB) has been reported. We report a prospective blinded randomized trial of PAI versus PNB in patients undergoing primary TKA, in accordance with the CONSORT statement 2010. METHODS: A total of 210 patients undergoing TKA under spinal anesthesia were randomized to receive PNB group or PAI group...
August 2014: Knee
https://www.readbyqxmd.com/read/24534592/additives-to-local-anesthetics-for-peripheral-nerve-blocks-evidence-limitations-and-recommendations
#20
REVIEW
Neil S Bailard, Jaime Ortiz, Roland A Flores
PURPOSE: The therapeutic rationale, clinical effectiveness, and potential adverse effects of medications used in combination with local anesthetics for peripheral nerve block therapy are reviewed. SUMMARY: A wide range of agents have been tested as adjuncts to peripheral nerve blocks, which are commonly performed for regional anesthesia during or after hand or arm surgery, neck or spine surgery, and other procedures. Studies to determine the comparative merits of nerve block adjuncts are complicated by the wide variety of coadministered local anesthetics and sites of administration and by the heterogeneity of primary endpoints...
March 1, 2014: American Journal of Health-system Pharmacy: AJHP
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