Dexamethasone as an Adjuvant to Ropivacaine for the Interscalene Brachial Plexus Block
Status:
Completed
Trial end date:
2018-11-01
Target enrollment:
Participant gender:
Summary
Shoulder surgery is associated with moderate to severe postoperative pain. Interscalene
brachial plexus block is considered by many as the gold standard for treating postoperative
pain and consists of injecting local anaesthetics close to the nerves of the brachial plexus
in the neck. Duration of analgesia is between eight to twelve hours depending on the type of
administered drugs. Dexamethasone 4 mg is a steroid routinely injected intravenously in
anaesthesia for the prophylaxis of postoperative nausea and vomiting. Recently, different
trials have demonstrated that combining 4 to 8 mg of dexamethasone with local anaesthetics
for a perineural injection may prolong the duration of analgesia up to 24 hours. In a
meta-analysis including 29 trials and 1695 patients, investigators have recently demonstrated
through a meta-regression that a dose of 4 mg is sufficient and represents a ceiling dose,
without neurological complications. The objective of this multicenter randomised controlled
double-blinded trial is to determine the optimal dose of perineural dexamethasone. For that
purpose, investigators will include a total of 150 patients divided in 5 groups: local
anaesthetics with placebo, or with dexamethasone 1, 2, 3 and 4 mg.