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Perineural dexamethasone reduces rebound pain after ropivacaine single injection interscalene block for arthroscopic shoulder surgery: a randomized controlled trial

Title
Perineural dexamethasone reduces rebound pain after ropivacaine single injection interscalene block for arthroscopic shoulder surgery: a randomized controlled trial
Authors
Woo, Jae HeeLee, Hyun JungOh, Hye-WonLee, Jong WhaBaik, Hee JungKim, Youn Jin
Ewha Authors
백희정김윤진우재희이종화오혜원이현정
SCOPUS Author ID
백희정scopus; 김윤진scopus; 우재희scopus; 오혜원scopusscopus; 이현정scopusscopus
Issue Date
2021
Journal Title
REGIONAL ANESTHESIA AND PAIN MEDICINE
ISSN
1098-7339JCR Link

1532-8651JCR Link
Citation
REGIONAL ANESTHESIA AND PAIN MEDICINE vol. 46, no. 11, pp. 965 - 970
Publisher
BMJ PUBLISHING GROUP
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Background and objectives A single injection interscalene block (ISB) is a common regional analgesic technique in patients undergoing arthroscopic shoulder surgery. However, rebound pain after ISB resolution may reduce its overall benefit. Our primary aim was to assess whether perineural dexamethasone reduces the intensity and incidence of rebound pain in patients undergoing arthroscopic shoulder surgery under general anesthesia combined with a preoperative single injection ISB. Methods The patients were randomly assigned to receive single injection ISB using either 0.5% ropivacaine (control) or 0.5% ropivacaine containing 5 mg of dexamethasone. The primary outcomes were the pain score difference before and after ISB resolution, and the incidence of rebound pain. The secondary outcomes were the onset and duration of rebound pain, the presence of sleep disturbances due to postoperative pain, the first time when an analgesic was requested, and pain scores at various predefined time points. Results Pain increase following ISB resolution was lower in the dexamethasone group compared with the control group (4.5 +/- 2.4 and 6.9 +/- 2.2, respectively, p<0.001). The incidence of rebound pain was significantly lower in the dexamethasone group compared with the control group (37.1% and 82.9%, respectively, p<0.001). The controls experienced greater sleep disturbance during the postoperative period compared with those who received ISB with perineural dexamethasone. Conclusions Perineural dexamethasone added to ISB using ropivacaine led to a much smoother resolution of ISB, reflected in a significantly smaller increase in pain after block resolution, a lower incidence of rebound pain and a lower sleep disturbance during the first postoperative week.
DOI
10.1136/rapm-2021-102795
Appears in Collections:
의과대학 > 의학과 > Journal papers
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