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

• 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
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/anae.16149

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.