Superior Block Length and Reduced Opioid Use with Dexmedetomidine and Dexamethasone regional block versus plain Ropivacaine : a retrospective trial
Purpose: The purpose of this study is to determine if using a combination of dexamethasone and dexmedetomidine (Dex-Dex) in a single-shot perineural local anesthestic provides an increased duration of pain relief and reduced consumption of opioids for patients undergoing shoulder surgery.
Patients and methods: This is a retrospective trial of adult patients without major comorbidities undergoing elective, upper arm orthopedic procedures with regional nerve block for post-operative analgesia. Patients underwent nerve block with either 0.5% ropivacaine or 0.2% ropivacaine with 5mg dexamethasone and 25mg dexmedetomidine ("dex-dex"). Patients were assessed in 1-week intervals for two weeks for duration of block analgesia, pain scores, and opioid use.
Results: 31 patients were included, 12 controls and 19 in the dex-dex group. These patients underwent one of arthroscopic rotator cuff repair, reverse total shoulder repair or repair of humerus fractures. Dex-dex blocks provided significantly longer analgesia (median block time 3.5 versus 1.5 days, p<0.0001), significantly better analgesia (mean NRS 2.32 versus 8.58 on post-operative day 1, p<0.0001), and significantly reduced opioid requirements (108.16mg vs 275.63mg in MME, p<0.0001). One patient experienced transient hypotension and prolonged paresthesia in the dex-dex group.
Conclusion: Preoperative single-shot interscalene nerve blocks with preservative-free dexamethasone and dexmedetomidine added as adjuvants to ropivicaine provide approximately two additional days of benefit versus ropivicaine alone. Additionally, postoperative opioid consumption is reduced.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
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| Enthalten in: |
Orthopedic reviews - 14(2022), 3 vom: 02., Seite 31921 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Berger, Amnon A [VerfasserIn] |
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| Links: |
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| Themen: |
Adjuvant |
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| Anmerkungen: |
Date Revised 22.11.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.52965/001c.31921 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM342958526 |
|---|
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| 024 | 7 | |a 10.52965/001c.31921 |2 doi | |
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| 245 | 1 | 0 | |a Superior Block Length and Reduced Opioid Use with Dexmedetomidine and Dexamethasone regional block versus plain Ropivacaine |b a retrospective trial |
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| 500 | |a Date Revised 22.11.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Purpose: The purpose of this study is to determine if using a combination of dexamethasone and dexmedetomidine (Dex-Dex) in a single-shot perineural local anesthestic provides an increased duration of pain relief and reduced consumption of opioids for patients undergoing shoulder surgery | ||
| 520 | |a Patients and methods: This is a retrospective trial of adult patients without major comorbidities undergoing elective, upper arm orthopedic procedures with regional nerve block for post-operative analgesia. Patients underwent nerve block with either 0.5% ropivacaine or 0.2% ropivacaine with 5mg dexamethasone and 25mg dexmedetomidine ("dex-dex"). Patients were assessed in 1-week intervals for two weeks for duration of block analgesia, pain scores, and opioid use | ||
| 520 | |a Results: 31 patients were included, 12 controls and 19 in the dex-dex group. These patients underwent one of arthroscopic rotator cuff repair, reverse total shoulder repair or repair of humerus fractures. Dex-dex blocks provided significantly longer analgesia (median block time 3.5 versus 1.5 days, p<0.0001), significantly better analgesia (mean NRS 2.32 versus 8.58 on post-operative day 1, p<0.0001), and significantly reduced opioid requirements (108.16mg vs 275.63mg in MME, p<0.0001). One patient experienced transient hypotension and prolonged paresthesia in the dex-dex group | ||
| 520 | |a Conclusion: Preoperative single-shot interscalene nerve blocks with preservative-free dexamethasone and dexmedetomidine added as adjuvants to ropivicaine provide approximately two additional days of benefit versus ropivicaine alone. Additionally, postoperative opioid consumption is reduced | ||
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| 650 | 4 | |a dexmedetomidine | |
| 650 | 4 | |a interscalene | |
| 650 | 4 | |a nerve block | |
| 700 | 1 | |a Syed, Zuby |e verfasserin |4 aut | |
| 700 | 1 | |a Ryan, Lianne |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Hasoon, Jamal |e verfasserin |4 aut | |
| 700 | 1 | |a Urits, Ivan |e verfasserin |4 aut | |
| 700 | 1 | |a Viswanath, Omar |e verfasserin |4 aut | |
| 700 | 1 | |a Cornett, Elyse M |e verfasserin |4 aut | |
| 700 | 1 | |a Kaye, Alan D |e verfasserin |4 aut | |
| 700 | 1 | |a Eskander, Jonathan P |e verfasserin |4 aut | |
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