caa a22 4500 445374330 CHVBK 20180317142958.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s00540-011-1180-x doi (NATIONALLICENCE)springer-10.1007/s00540-011-1180-x Adjuvant dexamethasone with bupivacaine prolongs the duration of interscalene block: a prospective randomized trial [Elektronische Daten] [Merle Tandoc, Liang Fan, Sergei Kolesnikov, Alexander Kruglov, Nader Nader] Purpose: To identify the effects of adding two different doses of dexamethasone on the duration and quality of interscalene block in patients undergoing shoulder surgery in ambulatory surgery settings. Methods: The study design was reviewed and approved by the University at Buffalo Institutional Review Board for Human Subjects. After obtaining informed consent, a total of 90 patients undergoing shoulder surgery using interscalene block with 0.5% bupivacaine (40mL) were assigned randomly to one of three groups: control patients, "Group C,” who received no additive; low dose, "Group L,” who received additional dexamethasone 4mg; and high dose, "Group H,” who received dexamethasone 8mg in addition to 0.5% bupivacaine. Postoperative analgesia was assessed using the numeric rating scores of pain and the postoperative consumption of acetaminophen 325mg+hydrocodone 7.5mg tablets. Analysis was by intention to treat. Statistical significance was tested using a two-way analysis of variance and a nonparametric analysis of variance for consumption of analgesics. Results: Four patients were excluded from the study due to either a failed block or inadequate follow-up. The duration of analgesia was significantly prolonged in both Group L (21.6±2.4h) and Group H (25.2±1.9h) compared with Group C (13.3±1.0h) (p<0.05). Similarly, the duration of motor block was longer in both Group L (36.7±4.1h), and Group H (39.2±3.9h) compared to Group C (24.6±3.3h) (p<0.05). Postoperative analgesic consumption for the first 48h was significantly lower in Group L (6.5 [4-8] tabs) and in Group H (5.5 [4-7] tabs) vs. 9.5 [8-12] tabs in Group C (p<0.01). There were no adverse events related to dexamethasone during the 4-week follow-up period. Conclusion: The addition of dexamethasone to bupivacaine significantly prolonged the duration of the motor block and improved the quality of analgesia following interscalene block. There was no difference in the duration of analgesia and motor block between low-dose and high-dose dexamethasone. Japanese Society of Anesthesiologists, 2011 Pain nationallicence Surgery nationallicence Interscalene block nationallicence Steroids nationallicence Local anesthesia nationallicence Tandoc Merle Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut Fan Liang Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut Kolesnikov Sergei Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut Kruglov Alexander Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut Nader Nader Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut Journal of Anesthesia Springer Japan 25/5(2011-10-01), 704-709 0913-8668 25:5<704 2011 25 540 https://doi.org/10.1007/s00540-011-1180-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1180-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tandoc Merle Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut NATIONALLICENCE 700 1- Fan Liang Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut NATIONALLICENCE 700 1- Kolesnikov Sergei Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut NATIONALLICENCE 700 1- Kruglov Alexander Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut NATIONALLICENCE 700 1- Nader Nader Department of Anesthesiology, SUNY-Buffalo, Buffalo, USA aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/5(2011-10-01), 704-709 0913-8668 25:5<704 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer