A randomised controlled trial of perineural vs intravenous dexamethasone for foot surgery

Anaesthesia. 2016 Mar;71(3):285-90. doi: 10.1111/anae.13346. Epub 2015 Dec 18.

Abstract

We used 20 ml ropivacaine 0.75% for ankle blocks before foot surgery in 90 participants who we allocated in equal numbers to: perineural dexamethasone 8 mg and intravenous saline 0.9%; perineural saline 0.9% and intravenous dexamethasone 8 mg; or perineural and intravenous saline 0.9%. Dexamethasone increased the median (IQR [range]) time for the return of some sensation or movement, from 14.6 (10.8-18.8 [5.5-38.0]) h with saline to 24.1 (19.3-29.3 [5.0-44.0]) h when given perineurally, p = 0.00098, and to 20.9 (18.3-27.8 [8.8-31.3]) h when given intravenously, p = 0.0067. Dexamethasone increased the median (IQR [range]) time for the return of normal neurology, from 17.6 (14.0-21.0 [9.5-40.5]) h with saline to 27.5 (22.0-36.3 [7.0-53.0]) h when given perineurally, p = 0.00016, and to 24.0 (20.5-32.3 [13.0-42.5]) h when given intravenously, p = 0.0022. Dexamethasone did not affect the rates of block success, postoperative pain scores, analgesic use, or nausea and vomiting. The route of dexamethasone administration did not alter its effects.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amides*
  • Anesthesia Recovery Period
  • Anesthetics, Local*
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use*
  • Female
  • Foot / surgery*
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Pain, Postoperative / drug therapy*
  • Ropivacaine
  • Sodium Chloride / administration & dosage
  • Time Factors

Substances

  • Amides
  • Anesthetics, Local
  • Glucocorticoids
  • Sodium Chloride
  • Ropivacaine
  • Dexamethasone