Dexamethasone Added to Mixed Local Anesthetics in Infraclavicular Block: The Dexamethasone Paradox in Chronic Pain.

IF 0.7 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Nigerian Journal of Clinical Practice Pub Date : 2025-08-01 Epub Date: 2025-08-30 DOI:10.4103/njcp.njcp_36_25
E M Simsek, H Kaşıkara
{"title":"Dexamethasone Added to Mixed Local Anesthetics in Infraclavicular Block: The Dexamethasone Paradox in Chronic Pain.","authors":"E M Simsek, H Kaşıkara","doi":"10.4103/njcp.njcp_36_25","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Dexamethasone is commonly used as an adjuvant to prolong analgesia in peripheral nerve blocks. However, there are a few studies available regarding its use in combination with mixed local anesthetics.</p><p><strong>Aim: </strong>This study investigated the effect of adding perineural dexamethasone to an infraclavicular block containing a medium- and long-acting local anesthetic mixture on the time to the first analgesia request (sensory block duration) as the primary outcome, as well as sensory and motor block onset times, motor block duration, postoperative analgesic use, and the development of long-term chronic pain as secondary outcomes.</p><p><strong>Materials and methods: </strong>This study included patients over 18 years of age and scheduled for upper extremity surgery. For patients in Group S, the block consisted of 10 mL of 0.5% bupivacaine, 5 mL of 2% prilocaine, and 5 mL of 0.9% saline solution. Patients in Group D received the same LA mixture with 2 mL of dexamethasone (8 mg) and 3 mL of 0.9% saline. Sensory and motor block level and Visual Analogue Scale (VAS) pain scores were recorded at postoperative 1, 12, and 24 hours. At least 6 months after surgery, the patients were contacted by phone and assessed for the presence of postoperative chronic pain, patient satisfaction, and whether they were receiving physical therapy.</p><p><strong>Results: </strong>Sensory block duration was significantly longer in the dexamethasone group. VAS scores at postoperative 12 hours and analgesic use were lower in the dexamethasone group. Long-term postoperative chronic pain was observed in one patient that received dexamethasone, but the difference between the groups was not significant.</p><p><strong>Conclusion: </strong>The addition of dexamethasone as an adjuvant to mixed local anesthetics in the infraclavicular block made a significant difference by reducing the need for postoperative analgesia.</p>","PeriodicalId":19431,"journal":{"name":"Nigerian Journal of Clinical Practice","volume":"28 8","pages":"955-961"},"PeriodicalIF":0.7000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nigerian Journal of Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4103/njcp.njcp_36_25","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/30 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Dexamethasone is commonly used as an adjuvant to prolong analgesia in peripheral nerve blocks. However, there are a few studies available regarding its use in combination with mixed local anesthetics.

Aim: This study investigated the effect of adding perineural dexamethasone to an infraclavicular block containing a medium- and long-acting local anesthetic mixture on the time to the first analgesia request (sensory block duration) as the primary outcome, as well as sensory and motor block onset times, motor block duration, postoperative analgesic use, and the development of long-term chronic pain as secondary outcomes.

Materials and methods: This study included patients over 18 years of age and scheduled for upper extremity surgery. For patients in Group S, the block consisted of 10 mL of 0.5% bupivacaine, 5 mL of 2% prilocaine, and 5 mL of 0.9% saline solution. Patients in Group D received the same LA mixture with 2 mL of dexamethasone (8 mg) and 3 mL of 0.9% saline. Sensory and motor block level and Visual Analogue Scale (VAS) pain scores were recorded at postoperative 1, 12, and 24 hours. At least 6 months after surgery, the patients were contacted by phone and assessed for the presence of postoperative chronic pain, patient satisfaction, and whether they were receiving physical therapy.

Results: Sensory block duration was significantly longer in the dexamethasone group. VAS scores at postoperative 12 hours and analgesic use were lower in the dexamethasone group. Long-term postoperative chronic pain was observed in one patient that received dexamethasone, but the difference between the groups was not significant.

Conclusion: The addition of dexamethasone as an adjuvant to mixed local anesthetics in the infraclavicular block made a significant difference by reducing the need for postoperative analgesia.

地塞米松加入混合局麻药治疗锁骨下阻滞:慢性疼痛的地塞米松悖论。
背景:地塞米松常被用作延长周围神经阻滞镇痛的辅助药物。然而,关于其与混合局部麻醉剂联合使用的研究很少。目的:本研究探讨了在含有中、长效局麻混合物的锁骨下阻滞中加入神经周地塞米松对首次镇痛时间(感觉阻滞持续时间)的影响,以及感觉和运动阻滞发生时间、运动阻滞持续时间、术后镇痛药物的使用和长期慢性疼痛的发展作为次要结果。材料和方法:本研究纳入年龄在18岁以上并计划进行上肢手术的患者。对于S组患者,阻滞包括10ml 0.5%布比卡因、5ml 2%丙洛卡因和5ml 0.9%生理盐水溶液。D组患者给予相同的LA混合液,加入2 mL地塞米松(8 mg)和3 mL 0.9%生理盐水。术后1、12、24小时分别记录感觉和运动阻滞水平及视觉模拟评分(VAS)疼痛评分。术后至少6个月,通过电话联系患者,评估术后慢性疼痛的存在、患者满意度以及是否接受物理治疗。结果:地塞米松组感觉阻滞持续时间明显延长。地塞米松组术后12小时VAS评分及镇痛药使用均较低。1例接受地塞米松治疗的患者术后出现长期慢性疼痛,组间差异无统计学意义。结论:在锁骨下阻滞混合局麻药的辅助下,加入地塞米松可显著减少术后镇痛的需要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Nigerian Journal of Clinical Practice
Nigerian Journal of Clinical Practice MEDICINE, GENERAL & INTERNAL-
CiteScore
1.40
自引率
0.00%
发文量
275
审稿时长
4-8 weeks
期刊介绍: The Nigerian Journal of Clinical Practice is a Monthly peer-reviewed international journal published by the Medical and Dental Consultants’ Association of Nigeria. The journal’s full text is available online at www.njcponline.com. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal makes a token charge for submission, processing and publication of manuscripts including color reproduction of photographs.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信