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Dexamethasone as adjuvant for femoral nerve block following knee arthroplasty: a randomized, controlled study
Author(s) -
Sherif A. A.,
Elsersy H. E.
Publication year - 2016
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12750
Subject(s) - medicine , bupivacaine , dexamethasone , anesthesia , morphine , surgery , femoral nerve , nerve block , femoral nerve block , arthroplasty
Background We examined the effect of the addition of dexamethasone to bupivacaine for femoral nerve blocks on the block duration and the quality of post‐operative analgesia following total knee replacement surgery. Methods In total, 200 ASA I– III patients were randomly allocated to either the control group who received bupivacaine 0.5% or the dexamethasone group who received bupivacaine 0.5% plus 8 mg dexamethasone for the femoral nerve block, followed by a continuous perineural bupivacaine infusion started at the time of block resolution. Patients were assessed for the duration of analgesia by the return of pinprick sensation and the 24‐h morphine consumption as the primary outcomes of the study. A numerical rating scale from 0 to 10 was used to assess post‐operative pain at zero, ½, 2, 6, 24, 48, and 72 h. Results There was no difference between groups in either sensory or motor block onset; however, the duration of the block was significantly prolonged in the dexamethasone group, 25.7 ± 3 h, vs. 18.8 ± 4 h in the control group P < 0.0001. The total morphine consumption was not different between groups, but the dexamethasone group consumed less morphine in the first 6 h post‐operatively. The addition of dexamethasone improved pain control on the first post‐operative day, but no difference in the pain score was detected on days 2 or 3. Conclusion The addition of dexamethasone to bupivacaine for femoral nerve block prolonged the duration of analgesia, improved early post‐operative pain following total knee arthroplasty.