Does dexamethasone improve the quality of intravenous regional anesthesia and analgesia? A randomized, controlled clinical study.

Abstract:

:We investigated the anesthetic and analgesic effectiveness of adding dexamethasone to lidocaine for IV regional anesthesia (IVRA). Seventy-five patients undergoing ambulatory hand surgery were randomly assigned to one of three groups: group L received 3 mg/kg lidocaine, group LD received 3 mg/kg lidocaine + 8 mg dexamethasone, and group LDc received 3 mg/kg lidocaine for IVRA and 8 mg dexamethasone IV to the nonsurgical arm. IVRA was established using 40 mL of a solution. Visual analog scale and verbal pain scores were recorded intraoperatively and for 2 h postoperatively. Postoperative pain was treated with oral acetaminophen 500 mg every 4 h when visual analog scale score was more than 3. Time to request for the first analgesic and the total dose in the first 24 h were noted. Times to onset of complete sensory and motor block were similar in the 3 groups. The times to recovery of motor block (L = 8 [5.91-10.08] min, LD = 13 [6.76-20.19] min, LDc = 6 [4.44-8.43] min) and sensory block (L = 7 [5.21-10.30] min, LD = 12 [6.11-19.40] min and LDc = 6 [4.2-8.11] min) were longer in group LD (P < 0.05). Patients in group LD reported significantly lower pain scores and required less acetaminophen in the first 24 h after surgery. In conclusion, the addition of 8 mg dexamethasone to lidocaine for IVRA in patients undergoing hand surgery improves postoperative analgesia during the first postoperative day.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Bigat Z,Boztug N,Hadimioglu N,Cete N,Coskunfirat N,Ertok E

doi

10.1213/01.ane.0000194944.54073.dd

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

605-9

issue

2

eissn

0003-2999

issn

1526-7598

pii

102/2/605

journal_volume

102

pub_type

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