TY - JOUR
T1 - A randomised controlled trial of intravenous dexamethasone combined with interscalene brachial plexus blockade for shoulder surgery
AU - Desmet, M.
AU - Vanneste, B.
AU - Reynvoet, M.
AU - Van Cauwelaert, J.
AU - Verhelst, L.
AU - Pottel, H.
AU - Missant, C.
AU - Van De Velde, M.
PY - 2015/10/1
Y1 - 2015/10/1
N2 - We recruited patients scheduled for shoulder rotator cuff repair or subacromial decompression under general anaesthesia and interscalene brachial plexus blockade (30 ml ropivacaine 0.5%). We allocated 240 participants into four groups of 60 that were given pre-operative saline 0.9% or dexamethasone 1.25 mg, 2.5 mg or 10 mg, intravenously. We recorded outcomes for 48 h. The median (IQR [range]) time to first postoperative analgesic request after saline was 12.2 (11.0-14.1 [1.8-48]) h, which was extended by intravenous dexamethasone 2.5 mg and 10 mg to 17.4 (14.9-21.5 [7.2-48]) h, p <0.0001, and 20.1 (17.2-24.3 [1.3-48]) h, p <0.0001, respectively, but not by dexamethasone 1.25 mg, 14.0 (12.1-17.7 [2.1-48]) h, p = 0.05. Postoperative analgesia was given sooner after rotator cuff repair than subacromial decompression, hazard ratio (95% CI) 2.2 (1.6-3.0), p <0.0001, but later in older participants, hazard ratio (95% CI) 0.98 (0.97-0.99) per year, p <0.0001.
AB - We recruited patients scheduled for shoulder rotator cuff repair or subacromial decompression under general anaesthesia and interscalene brachial plexus blockade (30 ml ropivacaine 0.5%). We allocated 240 participants into four groups of 60 that were given pre-operative saline 0.9% or dexamethasone 1.25 mg, 2.5 mg or 10 mg, intravenously. We recorded outcomes for 48 h. The median (IQR [range]) time to first postoperative analgesic request after saline was 12.2 (11.0-14.1 [1.8-48]) h, which was extended by intravenous dexamethasone 2.5 mg and 10 mg to 17.4 (14.9-21.5 [7.2-48]) h, p <0.0001, and 20.1 (17.2-24.3 [1.3-48]) h, p <0.0001, respectively, but not by dexamethasone 1.25 mg, 14.0 (12.1-17.7 [2.1-48]) h, p = 0.05. Postoperative analgesia was given sooner after rotator cuff repair than subacromial decompression, hazard ratio (95% CI) 2.2 (1.6-3.0), p <0.0001, but later in older participants, hazard ratio (95% CI) 0.98 (0.97-0.99) per year, p <0.0001.
U2 - 10.1111/anae.13156
DO - 10.1111/anae.13156
M3 - Article
C2 - 26082203
VL - 70
SP - 1180
EP - 1185
JO - Anaesthesia
JF - Anaesthesia
IS - 10
ER -