Preoperative administration of IV and perineural dexamethasone compared with saline did not improve overall QoR-40 or decrease opioid consumption but did prolong analgesic duration in patients undergoing elective foot and ankle surgery and receiving sciatic nerve block. Given the lack of clinical benefit and the concern of dexamethasone neurotoxicity as demonstrated in animal studies, the practice of perineural dexamethasone administration needs to be further evaluated.

Injecting 10 mL of 0.5% bupivacaine or ropivacaine below the CIEL produces comparable onset and duration of sensory and motor blockade as volumes as large as 30 mL.

P Pu ur rp po os se e: : To examine dose and lockout intervals for effective fentanyl patient-controlled analgesia (PCA) in second trimester genetic termination of pregnancy, and compare three different fentanyl PCA regimes with morphine PCA. M Me et th ho od ds s: :In a double-blind randomized study, 60 ASA physical status I-II patients received one of three fentanyl PCAs or morphine PCA. Labour was induced with prostaglandins and PCA use continued until delivery. Within two hours following delivery, four visual analogue scales (VAS) were administered measuring anticipated pain, pain relief in labour and delivery, and overall satisfaction. The drug delivery/demand ratio for two hours preceding delivery was obtained from the PCA pump. The outcome variables were analyzed using the Chi square test and analysis of variance as appropriate.R Re es su ul lt ts s: : The delivery/demand ratio was 0.71 ± 0.27 (mean ± standard deviation) for morphine; 0.67 ± 0.21 for fentanyl 50 µg, lockout six-minute; 0.63 ± 0.21 for fentanyl 25 µg, lockout threeminute; and 0.81 ± 0.17 for fentanyl 50 µg, lockout three-minute groups. We found no significant differences among the four groups with respect to using delivery/demand ratio as a measure of pain relief. Morphine had the highest rate of side effects compared to fentanyl. There was strong evidence of differences among groups with regard to patient satisfaction and expected pain, and moderate evidence of differences in the delivery and labour pain scores.C Co on nc cl lu us si io on n: : This study found PCA fentanyl 50 µg with a lockout period of six minutes provided satisfactory analgesia for second trimester labour. Objectif : Déterminer la dose et les périodes réfractaires d'une analgésie auto-contrôlée (AAC) efficace utilisée en cas d'interruption de grossesse génétique, et comparer trois régimes d'AAC avec fentanyl à la morphine en AAC. Méthode : Pendant l'étude randomisée et à double insu, 60 patientes d'état physique ASA I-II ont reçu l'un des trois régimes de fentanyl en AAC ou de la morphine en AAC. Le travail a été induit avec des prostaglandines et l'AAC continue a été utilisée jusqu'à l'accouchement. Pendant les deux premières heures après l'accouchement, la douleur attendue, le soulagement de la douleur du travail et de l'accouchement et la satisfaction générale ont été évalués grâce à quatre échelles visuelles analogiques (EVA). Pendant les deux heures précé-

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