The effect of perineural dexamethasone administered as an adjuvant in prolonging the duration of analgesia continues to be under debate. The investigators performed a prospective randomized study to evaluate the effect of perineural dexamethasone in different concentrations in postoperative analgesia in femoral nerve block for anterior cruciate ligament reconstruction.
After Ethics committee approval, 75 patients American Society of Anesthesiologists score (ASA) I-III were randomized at the end of surgery into 3 groups of 25 patients each who underwent femoral nerve block: group A with 20 ml ropivacaine 0,5% and 20 ml lidocaine 1%; group B with 20 ml ropivacaine 0,5%, 20 ml lidocaine 1% and 4 mg dexamethasone; group C with 20 ml ropivacaine 0,5%, 20 ml lidocaine 1% and 8 mg dexamethasone. All groups received postoperative analgesia when visual analog scale (VAS) over 3 (by request), with IV Perfalgan 1 g and morphine (loading dose 0.1 mg/kg and titration until VAS under 3, followed by subcutaneous (SC) administration of 1/2 of total loading dose on demand for the following 24 hours (h) . Efficacy was evaluated by the time interval from performing the block until the first analgesic dose required, the total amount of morphine in the first 24 h postoperative, the patient satisfaction and the neurological side effects.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
90
At the end of surgery the patients received single shot VIB block with the mixture according to the group allocation
After the block regression, at the first analgetic request the patients received the analgesia protocol
After the block regression, at the first analgetic request the patients received the analgesia protocol
Foisor Orthopedics Clinical Hospital
Bucharest, Romania
the total amount of morphine
the morphine administered in milligrams
Time frame: At 24 hour postoperative
the patient satisfaction
evaluation of satisfaction by a questionnaire
Time frame: At 24 hour postoperative
the number of patients with neurological motility side effects
Following the postoperative motility of operated lower limb by Bromage scale
Time frame: At 24 h postoperative
duration of analgesia
the time interval from performing the block until the first analgesic dose required at VAS \>3 (0 - no pain, 10 - the worst pain possible
Time frame: the first 24 hours
the number of patients with neurological sensibility side effects
Following postoperative sensibility of operated lower limb by pinprick test
Time frame: At 21 days postoperative
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At the end of surgery the patients received single shot VIB block with the mixture according to the group allocation
At the end of surgery the patients received single shot VIB block with the mixture according to the group allocation