{"title":"神经周围地塞米松加不同剂量罗哌卡因治疗斜角肌间臂丛阻滞术后镇痛效果评价：一项随机对照试验。","authors":"Qianqian Tang, Shihui Gao, Changming Wang, Zenglong Yan, Jing Zhang","doi":"10.1097/AJP.0000000000001301","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Interscalene brachial plexus block (ISBPB) has gained popularity as a pain-relief method following shoulder arthroscopic surgery, significantly reducing the need for analgesics. This study was designed to evaluate whether the addition of dexamethasone to different effective concentrations of ropivacaine in ultrasound-guided ISBPB affects postoperative analgesic effect in patients undergoing shoulder arthroscopy surgery.</p><p><strong>Materials and methods: </strong>A total of 140 subjects elected for shoulder arthroscopy under ISBPB and general anesthesia, randomized into six equal groups. Group A, B, and C received 10 mL 0.25%, 0.5%, and 0.75% ropivacaine mixed with 1 mL 0.9% saline, respectively. Likewise, Groups A1, B1, and C1 received the same volumes of ropivacaine with 5 mg dexamethasone. The primary goal was to assess the duration of analgesia with ISBPB, with secondary objectives concerning postoperative nausea and vomiting (PONV) and numerical rating scale (NRS) pain scores.</p><p><strong>Results: </strong>Across a range of ropivacaine concentrations, there was no significant difference in the analgesic efficacy between subjects receiving dexamethasone treatment and those who did not. Notably, there was no demonstrable difference in the duration of analgesia among the treatment groups (Group A vs. Group A1: 510.13±262.39 min, 518.21±395.49 min; P=0.054); (Group B vs. Group B1: 672.42±306.63 min, 646.05±348.48 min; P=0.281); (Group C vs. Group C1: 724.42±384.14 min, 680.29±414.30 min; P=0.782). Furthermore, there was no significant difference in the incidence of intraoperative and postoperative complications.</p><p><strong>Conclusion: </strong>The present study indicated that the addition of dexamethasone to ropivacaine did not appear to provide any additional advantages in postoperative analgesic efficacy compared to the use of ropivacaine alone for patients undergoing shoulder arthroscopy surgery with ISBPB.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Postoperative Analgesia Effect Evaluation of Perineural Dexamethasone Plus Various Doses of Ropivacaine in Interscalene Brachial Plexus Block: A Randomized Controlled Trial.\",\"authors\":\"Qianqian Tang, Shihui Gao, Changming Wang, Zenglong Yan, Jing Zhang\",\"doi\":\"10.1097/AJP.0000000000001301\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Interscalene brachial plexus block (ISBPB) has gained popularity as a pain-relief method following shoulder arthroscopic surgery, significantly reducing the need for analgesics. This study was designed to evaluate whether the addition of dexamethasone to different effective concentrations of ropivacaine in ultrasound-guided ISBPB affects postoperative analgesic effect in patients undergoing shoulder arthroscopy surgery.</p><p><strong>Materials and methods: </strong>A total of 140 subjects elected for shoulder arthroscopy under ISBPB and general anesthesia, randomized into six equal groups. Group A, B, and C received 10 mL 0.25%, 0.5%, and 0.75% ropivacaine mixed with 1 mL 0.9% saline, respectively. Likewise, Groups A1, B1, and C1 received the same volumes of ropivacaine with 5 mg dexamethasone. The primary goal was to assess the duration of analgesia with ISBPB, with secondary objectives concerning postoperative nausea and vomiting (PONV) and numerical rating scale (NRS) pain scores.</p><p><strong>Results: </strong>Across a range of ropivacaine concentrations, there was no significant difference in the analgesic efficacy between subjects receiving dexamethasone treatment and those who did not. Notably, there was no demonstrable difference in the duration of analgesia among the treatment groups (Group A vs. Group A1: 510.13±262.39 min, 518.21±395.49 min; P=0.054); (Group B vs. Group B1: 672.42±306.63 min, 646.05±348.48 min; P=0.281); (Group C vs. Group C1: 724.42±384.14 min, 680.29±414.30 min; P=0.782). Furthermore, there was no significant difference in the incidence of intraoperative and postoperative complications.</p><p><strong>Conclusion: </strong>The present study indicated that the addition of dexamethasone to ropivacaine did not appear to provide any additional advantages in postoperative analgesic efficacy compared to the use of ropivacaine alone for patients undergoing shoulder arthroscopy surgery with ISBPB.</p>\",\"PeriodicalId\":50678,\"journal\":{\"name\":\"Clinical Journal of Pain\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-05-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Journal of Pain\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/AJP.0000000000001301\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Journal of Pain","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/AJP.0000000000001301","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
Postoperative Analgesia Effect Evaluation of Perineural Dexamethasone Plus Various Doses of Ropivacaine in Interscalene Brachial Plexus Block: A Randomized Controlled Trial.
Objectives: Interscalene brachial plexus block (ISBPB) has gained popularity as a pain-relief method following shoulder arthroscopic surgery, significantly reducing the need for analgesics. This study was designed to evaluate whether the addition of dexamethasone to different effective concentrations of ropivacaine in ultrasound-guided ISBPB affects postoperative analgesic effect in patients undergoing shoulder arthroscopy surgery.
Materials and methods: A total of 140 subjects elected for shoulder arthroscopy under ISBPB and general anesthesia, randomized into six equal groups. Group A, B, and C received 10 mL 0.25%, 0.5%, and 0.75% ropivacaine mixed with 1 mL 0.9% saline, respectively. Likewise, Groups A1, B1, and C1 received the same volumes of ropivacaine with 5 mg dexamethasone. The primary goal was to assess the duration of analgesia with ISBPB, with secondary objectives concerning postoperative nausea and vomiting (PONV) and numerical rating scale (NRS) pain scores.
Results: Across a range of ropivacaine concentrations, there was no significant difference in the analgesic efficacy between subjects receiving dexamethasone treatment and those who did not. Notably, there was no demonstrable difference in the duration of analgesia among the treatment groups (Group A vs. Group A1: 510.13±262.39 min, 518.21±395.49 min; P=0.054); (Group B vs. Group B1: 672.42±306.63 min, 646.05±348.48 min; P=0.281); (Group C vs. Group C1: 724.42±384.14 min, 680.29±414.30 min; P=0.782). Furthermore, there was no significant difference in the incidence of intraoperative and postoperative complications.
Conclusion: The present study indicated that the addition of dexamethasone to ropivacaine did not appear to provide any additional advantages in postoperative analgesic efficacy compared to the use of ropivacaine alone for patients undergoing shoulder arthroscopy surgery with ISBPB.
期刊介绍：
The Clinical Journal of Pain explores all aspects of pain and its effective treatment, bringing readers the insights of leading anesthesiologists, surgeons, internists, neurologists, orthopedists, psychiatrists and psychologists, clinical pharmacologists, and rehabilitation medicine specialists. This peer-reviewed journal presents timely and thought-provoking articles on clinical dilemmas in pain management; valuable diagnostic procedures; promising new pharmacological, surgical, and other therapeutic modalities; psychosocial dimensions of pain; and ethical issues of concern to all medical professionals. The journal also publishes Special Topic issues on subjects of particular relevance to the practice of pain medicine.
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