Perineural or intravenous dexamethasone in interscalene brachial plexus block

Kirkham, Kyle R.; Albrecht, Éric

doi:10.1016/j.bja.2019.09.010

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…PNB prolongation has been observed after the administration of DEXA by either the perineural or intravenous (IV) route [ 9 ]. The literature suggests that 4 mg of DEXA may be the optimal perineural dose to potentiate PNB, whereas the optimal intravenous dose is likely higher but still remains undetermined [ 10 ]. However, the intravenous administration should be preferred because perineural use may cause delayed neurotoxicity and the perineural route is still off-label [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Intravenous Dexamethasone Dose on the Occurrence of Rebound Pain after Axillary Plexus Block in Ambulatory Surgery

Touil

Pavlopoulou

Delande

et al. 2023

JCM

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Rebound pain (RP) remains a challenge in ambulatory surgery, characterized by severe pain upon resolution of a peripheral nerve block (PNB). Intravenous (IV) administration of Dexamethasone (DEXA) potentiates PNB analgesic effect and reduces RP incidence although preventive effective dose remains undetermined. This retrospective analysis evaluates the preventive effect of IV DEXA on RP in outpatients undergoing upper limb surgery under axillary block. DEXA was divided into high (HD > 0.1 mg/kg) or low (LD < 0.1 mg/kg) doses. RP was defined as severe pain (NRS ≥ 7/10) within 24 h of PNB resolution. DEXA HD and LD patients were matched with control patients without DEXA (n = 55) from a previous randomized controlled study. Records of 118 DEXA patients were analyzed (DEXA dose ranged from 0.05 to 0.12 mg/kg). Intraoperative IV DEXA was associated with a significant reduction of the pain felt when PNB wore off as well as to a significant reduction of RP incidence (n = 27/118, 23% vs. 47% in controls, p = 0.002) with no effect related to the dose administered (p = 0.053). Our results support the administration of intraoperative DEXA as a preventive measure to reduce the occurrence of RP.

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Section: Introductionmentioning

confidence: 99%