PMID- 30857609
OWN - NLM
STAT- MEDLINE
DCOM- 20190422
LR  - 20210109
IS  - 1471-6771 (Electronic)
IS  - 0007-0912 (Print)
IS  - 0007-0912 (Linking)
VI  - 122
IP  - 4
DP  - 2019 Apr
TI  - Dexamethasone as an adjuvant for peripheral nerve blockade: a randomised, 
      triple-blinded crossover study in volunteers.
PG  - 525-531
LID - S0007-0912(19)30016-9 [pii]
LID - 10.1016/j.bja.2019.01.004 [doi]
AB  - BACKGROUND: The efficacy of dexamethasone in extending the duration of local 
      anaesthetic block is uncertain. In a randomised controlled triple blind crossover 
      study in volunteers, we tested the hypothesis that neither i.v. nor perineurally 
      administered dexamethasone prolongs the sensory block achieved with ropivacaine. 
      METHODS: Ultrasound-guided ulnar nerve blocks (ropivacaine 0.75% wt/vol, 3 ml, 
      with saline 1 ml with or without dexamethasone 4 mg) were performed on three 
      occasions in 24 male volunteers along with an i.v. injection of saline 1 ml with 
      or without dexamethasone 4 mg. The combinations of saline and dexamethasone were 
      as follows: control group, perineural and i.v. saline; perineural group, 
      perineural dexamethasone and i.v. saline; i.v. group, perineural saline and i.v. 
      dexamethasone. Sensory block was measured using a VAS in response to pinprick 
      testing. The duration of sensory block was the primary outcome and time to onset 
      of sensory block the secondary outcome. RESULTS: All 24 subjects completed the 
      trial. The median [inter-quartile range (IQR)] duration of sensory block was 6.87 
      (5.85-7.62) h in the control group, 7.37 (5.78-7.93) h in the perineural group 
      and 7.37 (6.10-7.97) h in the i.v. group (P=0.61). There was also no significant 
      difference in block onset time between the three groups. CONCLUSION: 
      Dexamethasone 4 mg has no clinically relevant effect on the duration of sensory 
      block provided by ropivacaine applied to the ulnar nerve. CLINICAL TRIAL 
      REGISTRATION: DRKS, 00014604; EudraCT, 2018-001221-98.
CI  - Copyright (c) 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Marhofer, Peter
AU  - Marhofer P
AD  - Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical 
      University of Vienna, Vienna, Austria. Electronic address: 
      peter.marhofer@meduniwien.ac.at.
FAU - Columb, Malachy
AU  - Columb M
AD  - Department of Anaesthesia, Manchester University Hospitals Foundation Trust, 
      Wythenshawe, UK.
FAU - Hopkins, Phil M
AU  - Hopkins PM
AD  - Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, 
      UK.
FAU - Greher, Manfred
AU  - Greher M
AD  - Department of Anaesthesia, Intensive Care Medicine and Pain Therapy, Herz Jesu 
      Hospital Vienna, Vienna, Austria.
FAU - Marhofer, Daniela
AU  - Marhofer D
AD  - Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical 
      University of Vienna, Vienna, Austria.
FAU - Bienzle, Max
AU  - Bienzle M
AD  - Department of Clinical Pharmacology, Medical University of Vienna, Vienna, 
      Austria.
FAU - Zeitlinger, Markus
AU  - Zeitlinger M
AD  - Department of Clinical Pharmacology, Medical University of Vienna, Vienna, 
      Austria.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20190131
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
RN  - 0 (Adjuvants, Anesthesia)
RN  - 0 (Anesthetics, Local)
RN  - 7IO5LYA57N (Ropivacaine)
RN  - 7S5I7G3JQL (Dexamethasone)
SB  - IM
CIN - Br J Anaesth. 2019 Apr;122(4):411-412. PMID: 30857596
MH  - Adjuvants, Anesthesia/*administration & dosage
MH  - Adolescent
MH  - Adult
MH  - Anesthetics, Local/*administration & dosage
MH  - Cross-Over Studies
MH  - Dexamethasone/*administration & dosage
MH  - Double-Blind Method
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nerve Block/*methods
MH  - Ropivacaine/administration & dosage
MH  - Time Factors
MH  - Ulnar Nerve/diagnostic imaging
MH  - Ultrasonography, Interventional/methods
MH  - Young Adult
PMC - PMC6435911
OTO - NOTNLM
OT  - dexamethasone
OT  - local anaesthetics
OT  - regional anaesthesia
OT  - ropivacaine
OT  - ulnar nerve block
OT  - ultrasound-guided
EDAT- 2019/03/13 06:00
MHDA- 2019/04/23 06:00
PMCR- 2019/01/31
CRDT- 2019/03/13 06:00
PHST- 2018/11/09 00:00 [received]
PHST- 2018/12/30 00:00 [revised]
PHST- 2019/01/02 00:00 [accepted]
PHST- 2019/03/13 06:00 [entrez]
PHST- 2019/03/13 06:00 [pubmed]
PHST- 2019/04/23 06:00 [medline]
PHST- 2019/01/31 00:00 [pmc-release]
AID - S0007-0912(19)30016-9 [pii]
AID - 10.1016/j.bja.2019.01.004 [doi]
PST - ppublish
SO  - Br J Anaesth. 2019 Apr;122(4):525-531. doi: 10.1016/j.bja.2019.01.004. Epub 2019 
      Jan 31.