Comparison between low-volume local anesthetic with intravenous dexamethasone and conventional volume without dexamethasone for superior trunk block after arthroscopic shoulder surgery : a randomized controlled non-inferiority trial
© American Society of Regional Anesthesia & Pain Medicine 2023. No commercial re-use. See rights and permissions. Published by BMJ..
INTRODUCTION: This study aimed to investigate whether low-volume local anesthetic with intravenous dexamethasone can reduce the incidence of diaphragmatic paresis while maintaining the analgesic duration compared with conventional volume of local anesthetic without intravenous dexamethasone when performing ultrasound-guided superior trunk block in patients undergoing arthroscopic shoulder surgery.
METHODS: Eighty-four adult patients undergoing arthroscopic shoulder surgery under general anesthesia were randomly assigned to receive ultrasound-guided superior trunk block using 7 mL of 0.5% ropivacaine with 0.15 mg/kg of intravenous dexamethasone (treatment group), or 15 mL of 0.5% ropivacaine with intravenous normal saline (control group). The co-primary outcomes were (1) the duration of analgesia (time between block completion and onset of surgical pain with a Numeric Rating Scale pain score of 4 or higher), which was compared against a non-inferiority margin of 3 hours, and (2) the incidence of diaphragmatic paresis evaluated using M-mode ultrasonography in the post-anesthesia care unit.
RESULTS: The mean duration of analgesia was 12.4 (6.8) and 11.2 (4.6) hours in the treatment and control groups, respectively (mean difference: -1.2 hours; 95% CI -3.8 to 1.3]; p for non-inferiority<0.001), meeting the non-inferiority criteria. The incidence of diaphragmatic paresis was 45.2% and 85.4% in the treatment and control groups, respectively (relative risk: 0.53; 97.5% CI 0.35 to 0.80; p<0.001).
CONCLUSIONS: Superior trunk block using low-volume local anesthetic with intravenous dexamethasone can reduce the incidence of diaphragmatic paresis while providing non-inferior analgesic duration compared with the conventional volume of local anesthetic in patients undergoing arthroscopic shoulder surgery.
TRIAL REGISTRATION NUMBER: Clinical Research Information Service of Republic of Korea Registry (KCT0005998).
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
|---|---|
| Enthalten in: |
Regional anesthesia and pain medicine - (2023) vom: 29. Sept. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Kim, Youngwon [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Acute Pain |
|---|
| Anmerkungen: |
Date Revised 29.09.2023 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1136/rapm-2023-104520 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM362713480 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM362713480 | ||
| 003 | DE-627 | ||
| 005 | 20231226091815.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1136/rapm-2023-104520 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1208.xml |
| 035 | |a (DE-627)NLM362713480 | ||
| 035 | |a (NLM)37775273 | ||
| 035 | |a (PII)rapm-2023-104520 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Kim, Youngwon |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Comparison between low-volume local anesthetic with intravenous dexamethasone and conventional volume without dexamethasone for superior trunk block after arthroscopic shoulder surgery |b a randomized controlled non-inferiority trial |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 29.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © American Society of Regional Anesthesia & Pain Medicine 2023. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a INTRODUCTION: This study aimed to investigate whether low-volume local anesthetic with intravenous dexamethasone can reduce the incidence of diaphragmatic paresis while maintaining the analgesic duration compared with conventional volume of local anesthetic without intravenous dexamethasone when performing ultrasound-guided superior trunk block in patients undergoing arthroscopic shoulder surgery | ||
| 520 | |a METHODS: Eighty-four adult patients undergoing arthroscopic shoulder surgery under general anesthesia were randomly assigned to receive ultrasound-guided superior trunk block using 7 mL of 0.5% ropivacaine with 0.15 mg/kg of intravenous dexamethasone (treatment group), or 15 mL of 0.5% ropivacaine with intravenous normal saline (control group). The co-primary outcomes were (1) the duration of analgesia (time between block completion and onset of surgical pain with a Numeric Rating Scale pain score of 4 or higher), which was compared against a non-inferiority margin of 3 hours, and (2) the incidence of diaphragmatic paresis evaluated using M-mode ultrasonography in the post-anesthesia care unit | ||
| 520 | |a RESULTS: The mean duration of analgesia was 12.4 (6.8) and 11.2 (4.6) hours in the treatment and control groups, respectively (mean difference: -1.2 hours; 95% CI -3.8 to 1.3]; p for non-inferiority<0.001), meeting the non-inferiority criteria. The incidence of diaphragmatic paresis was 45.2% and 85.4% in the treatment and control groups, respectively (relative risk: 0.53; 97.5% CI 0.35 to 0.80; p<0.001) | ||
| 520 | |a CONCLUSIONS: Superior trunk block using low-volume local anesthetic with intravenous dexamethasone can reduce the incidence of diaphragmatic paresis while providing non-inferior analgesic duration compared with the conventional volume of local anesthetic in patients undergoing arthroscopic shoulder surgery | ||
| 520 | |a TRIAL REGISTRATION NUMBER: Clinical Research Information Service of Republic of Korea Registry (KCT0005998) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute Pain | |
| 650 | 4 | |a Brachial Plexus | |
| 650 | 4 | |a Nerve Block | |
| 650 | 4 | |a Pain Management | |
| 650 | 4 | |a Upper Extremity | |
| 700 | 1 | |a Yoo, Seokha |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Sae Hoon |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Hansol |e verfasserin |4 aut | |
| 700 | 1 | |a Bae, Jinyoung |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Sun-Kyung |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Jin-Tae |e verfasserin |4 aut | |
| 700 | 1 | |a Lim, Young-Jin |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Regional anesthesia and pain medicine |d 1998 |g (2023) vom: 29. Sept. |w (DE-627)NLM09493827X |x 1532-8651 |7 nnns |
| 773 | 1 | 8 | |g year:2023 |g day:29 |g month:09 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1136/rapm-2023-104520 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2023 |b 29 |c 09 | ||