Perineural Dexamethasone as a Peripheral Nerve Block Adjuvant in the Emergency Department: A Case Series

J Emerg Med. 2021 Nov;61(5):574-580. doi: 10.1016/j.jemermed.2021.03.032.

Abstract

Background: Acute pain is one of the most common complaints encountered in the emergency department (ED). Single-injection peripheral nerve blocks are a safe and effective pain management tool when performed in the ED. Dexamethasone has been explored as an adjuvant to prolong duration of analgesia from peripheral nerve blocks in peri- and postoperative settings; however, data surrounding the use of dexamethasone for ED-performed nerve blocks are lacking.

Case series: In this case series we discuss our experience with adjunctive perineural dexamethasone in ED-performed regional anesthesia. Why Should an Emergency Physician be Aware of This?: Nerve blocks performed with adjuvant perineural dexamethasone may be a safe additive to provide analgesia beyond the expected half-life of local anesthetic alone. Prospective studies exploring the role of adjuvant perineural dexamethasone in ED-performed nerve blocks are needed. © 2021 Elsevier Inc.

Keywords: dexamethasone; emergency department; nerve block; pain; perineural; procedural ultrasound.

MeSH terms

  • Anesthesia, Conduction*
  • Anesthetics, Local / therapeutic use
  • Dexamethasone* / therapeutic use
  • Emergency Service, Hospital
  • Humans
  • Pain, Postoperative / drug therapy
  • Peripheral Nerves
  • Prospective Studies

Substances

  • Anesthetics, Local
  • Dexamethasone