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A randomised controlled trial of intravenous dexamethasone combined with interscalene brachial plexus blockade for shoulder surgery
Author(s) -
Desmet M.,
Vanneste B.,
Reynvoet M.,
Van Cauwelaert J.,
Verhelst L.,
Pottel H.,
Missant C.,
Van de Velde M.
Publication year - 2015
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13156
Subject(s) - medicine , dexamethasone , anesthesia , rotator cuff , brachial plexus , ropivacaine , blockade , saline , surgery , decompression , hazard ratio , confidence interval , receptor
Summary We recruited patients scheduled for shoulder rotator cuff repair or subacromial decompression under general anaesthesia and interscalene brachial plexus blockade (30 ml ropivacaine 0.5%). We allocated 240 participants into four groups of 60 that were given pre‐operative saline 0.9% or dexamethasone 1.25 mg, 2.5 mg or 10 mg, intravenously. We recorded outcomes for 48 h. The median (IQR [range]) time to first postoperative analgesic request after saline was 12.2 (11.0–14.1 [1.8–48]) h, which was extended by intravenous dexamethasone 2.5 mg and 10 mg to 17.4 (14.9–21.5 [7.2–48]) h, p < 0.0001, and 20.1 (17.2–24.3 [1.3–48]) h, p < 0.0001, respectively, but not by dexamethasone 1.25 mg, 14.0 (12.1–17.7 [2.1–48]) h, p = 0.05. Postoperative analgesia was given sooner after rotator cuff repair than subacromial decompression, hazard ratio (95% CI) 2.2 (1.6–3.0), p < 0.0001, but later in older participants, hazard ratio (95% CI) 0.98 (0.97–0.99) per year, p < 0.0001.