The effect of oral dexamethasone on duration of analgesia after upper limb surgery under infraclavicular brachial plexus block: a randomised controlled trial

The effect of oral dexamethasone on duration of analgesia after upper limb surgery under infraclavicular brachial plexus block: a randomised controlled trial

Summary The effects of oral dexamethasone on peripheral nerve blocks have not been investigated. We randomly allocated adults scheduled for forearm or hand surgery to oral placebo (n = 61), dexamethasone 12 mg (n = 61) or dexamethasone 24 mg (n = 57) about 45 min before lateral infraclavicular block...

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Published in:Anaesthesia Vol. 78; no. 12; pp. 1465 - 1471
Main Authors: Maagaard, M., Plambech, M. Z., Funder, K. S., Schou, N. K., Mølgaard, A. K., Stormholt, E. R., Leth, M. F., Bukhari, S., Mortensen, A., Lunn, T. H., Tryggedsson, I., Nørskov, A. K., Zamany, C., Toquer, P., Jæger, P., Andersen, J. H., Mathiesen, O.
Format: Journal Article
Language:English
Published: Oxford Blackwell Publishing Ltd 01-12-2023
Subjects:
Analgesia
Brachial plexus
Clinical outcomes
Dexamethasone
dexamethasone adjunct
infraclavicular
Limbs
Pain
Pain management
Pain perception
peripheral nerve block
Peripheral nerves
Placebos
Postoperative period
randomised clinical trial
regional anaesthesia
Regional anesthesia
Surgery
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Summary:Summary The effects of oral dexamethasone on peripheral nerve blocks have not been investigated. We randomly allocated adults scheduled for forearm or hand surgery to oral placebo (n = 61), dexamethasone 12 mg (n = 61) or dexamethasone 24 mg (n = 57) about 45 min before lateral infraclavicular block. Mean (SD) time until first pain after block were: 841 (327) min; 1171 (318) min; and 1256 (395) min, respectively. Mean (98.3%CI) differences in time until first postoperative pain for dexamethasone 24 mg vs. placebo and vs. dexamethasone 12 mg were: 412 (248–577) min, p < 0.001; and 85 (‐78 to 249) min, p = 0.21, respectively. Mean (98.3%CI) difference in time until first postoperative pain for dexamethasone 12 mg vs. placebo was 330 (186–474) min, p < 0.001. Both 24 mg and 12 mg of oral dexamethasone increased the time until first postoperative pain compared with placebo in patients having upper limb surgery under infraclavicular brachial plexus block.
Bibliography:1 Foundation doctor, 4 Medical Student, 6 Foundation doctor, 13 Clinical Associate Professor, 14 Professor, Centre for Anaesthesiological Research, Department of Anaesthesiology, Trauma Unit, Zealand University Hospital, Køge, Denmark
3 Specialist registrar, 7 Clinical Associate Professor, Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Denmark
8 Foundation doctor, Department of Orthopaedic Surgery and Traumatology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Denmark
9 Consultant, Department of Anaesthesiology, Copenhagen University Hospital, North Zealand Hospital, Hillerød, Denmark
10 Foundation doctor, 11 Consultant, Department of Orthopaedic Surgery, Trauma Unit, Zealand University Hospital, Køge, Denmark
12 Specialist registrar, Department of Anaesthesia, the Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
2 Consultant, 5 Specialist Registrar, Department of Anaesthesiology, Næstved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
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ISSN:0003-2409
1365-2044
DOI:10.1111/anae.16149