The addition of the steroid dexamethasone to a single injection of local anesthetic has been shown to significantly prolong the duration of peripheral nerve blockade compared to local anesthetic alone. This allows for improved post-operative pain scores and reduces opioid use in the early post-operative period. However, the use of a steroid adjuvant in regional nerve blocks is generally not considered standard of care, and there is considerable variation among anesthesiologists regarding preferred formulations and the role of adjuvants in regional anesthesia. A recent study from our institution demonstrated the effectiveness of dexamethasone directly mixed with local anesthetic at multiple doses compared to placebo for upper extremity surgery. With this prospective randomized controlled blinded trial, we hope to definitively establish which method of adjuvant dexamethasone administration is superior in extending the effects of a brachial plexus nerve block.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
50
4 mg of Dexamethasone will be given before surgery
Ultrasound guided supraclavicular block with ropivacaine will be given to patients before surgery
Rothman Orthopaedic Institute
Philadelphia, Pennsylvania, United States
Postoperative pain control
Measured using participants Visual Analog Scale (VAS) pain scores
Time frame: 72 hours
Postoperative pain control #2 questionnaire
Measured by asking participants how much medication they take after surgery to help control their pain
Time frame: 72 hours
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