Postoperative Pain and Other Acute Pain Syndromes

Williams, Brian A.; Neumann, Krystof J.; Goel, Shiv; Wu, Christopher L.

doi:10.1016/b978-032304184-3.50017-0

Cited by 5 publications

(3 citation statements)

References 391 publications

(396 reference statements)

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“…Dexamethasone is not approved as a perineural adjuvant in the USA or in Europe. As a component of the institutional review board approval process, the literature on the safety of its use in this setting was presented , reviewed and ultimately determined to be acceptable for trial in human subjects.…”

Section: Methodsmentioning

confidence: 99%

Perineural versus intravenous dexamethasone as adjuncts to local anaesthetic brachial plexus block for shoulder surgery

Rosenfeld

Ivancic²,

Hattrup

et al. 2016

Anaesthesia

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SummaryThis randomised, double-blind, placebo-controlled study compared the effect of perineural with intravenous dexamethasone, both administered concomitantly with interscalene brachial plexus block for shoulder surgery. Patients received 8 mg dexamethasone mixed with ropivacaine in the block injection (n = 42), 8 mg dexamethasone intravenously at the time of the block (n = 37), or intravenous saline (n = 41) at the time of the block. Perineural and intravenous dexamethasone resulted in prolonged mean (SD) duration of block to 16.9 (5.2) h and 18.2 (6.4) h, respectively, compared with 13.8 (3.8) h for saline (p = 0.001). Mean (SD) opioid consumption (morphine equivalents) during the first 24 h after postanaesthesia recovery arrival was 12.2 (9.3) mg in the perineural dexamethasone, 17.1 (15.9) mg in the intravenous dexamethasone and 24.1 (14.3) mg in the saline groups (p = 0.001). Dexamethasone via either route reduced anti-emetic use (p = 0.046). There was no effect on patient satisfaction. These results suggest that both perineural and intravenous dexamethasone are useful adjuncts to ropivacaine interscalene block, with the intravenous route preferred as this avoids the possibility of neural toxicity of dexamethasone.

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Section: Methodsmentioning

confidence: 99%

Perineural versus intravenous dexamethasone as adjuncts to local anaesthetic brachial plexus block for shoulder surgery

Rosenfeld

Ivancic²,

Hattrup

et al. 2016

Anaesthesia

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“…However, the use of dexamethasone at doses between 4 and 12 mg via the intravenous, perineural, and epidural routes is described in regional anesthesia and pain medicine textbooks. 18,19 Reports of corticosteroid-mediated neurotoxicity seem to be related to the vehicle polyethylene glycol and the preservative benzyl alcohol in steroid preparations as well as the presence of insoluble steroid particulate matter in the injectate. 20,21 In vivo and in vitro animal studies have demonstrated that locally applied corticosteroids have no long-term effect on the structure, electrical properties, or function of peripheral nerves 22 and that the extrafascicular and intrafascicular injection of dexamethasone in a rat sciatic nerve experimental model caused no or minimal peripheral nerve damage, respectively, when compared with other steroids such as hydrocortisone or triamcinolone.…”

mentioning

confidence: 98%

Dexamethasone Added to Mepivacaine Prolongs the Duration of Analgesia After Supraclavicular Brachial Plexus Blockade

Parrington

O’Donnell

Chan

et al. 2010

Regional Anesthesia and Pain Medicine

166

136

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“…Most of the interventions in acute pain setting would involve peripheral nerve blocks, single shot or continuous neuraxial blocks. 2 Neuraxial anaesthesia can be very useful for the treatment of pain in trauma patients and after procedures, such as laparotomy, thoracotomy and reduction of extremity fractures. Paravertebral blocks may be helpful in rib fractures and peripheral nerve blocks may be helpful in limb injuries.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound in Acute and Chronic Pain Medicine

Gupta¹,

McGlennan²,

Harmon³

2012

IJPUT

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Ultrasound is becoming popular in anaesthetic practice because of numerous advantages. Its introduction in pain medicine is recent and its use is growing. It allows the identification of soft tissues, vessels and nerves, without the risk of radiation. The additional advantages in pain medicine are avoidance of repeated radiations and ease of use in outpatient clinics, thus saving time and decreasing work load on interventional theatres. Ultrasound has multiple applications in pain medicine. It finds use in providing acute pain relief in the form of peripheral nerve blocks. In chronic pain, possible applications include blocks of cervical and lumbar facet joints, stellate ganglion block, intercostal nerve blocks, blocks of painful stump neuromas, caudal epidural injections and injections of trigger or tender points. The nerves can be visualised directly, thus helping in destructive processes like cryoanalgesia, radiofrequency lesioning and chemical neurolysis. The disadvantages are loss of resolution for deep-seated structures and lack of controlled trials. The article presents a review of ultrasound usage in acute and chronic pain interventional procedures.

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Postoperative Pain and Other Acute Pain Syndromes

Cited by 5 publications

References 391 publications

Perineural versus intravenous dexamethasone as adjuncts to local anaesthetic brachial plexus block for shoulder surgery

Perineural versus intravenous dexamethasone as adjuncts to local anaesthetic brachial plexus block for shoulder surgery

Dexamethasone Added to Mepivacaine Prolongs the Duration of Analgesia After Supraclavicular Brachial Plexus Blockade

Ultrasound in Acute and Chronic Pain Medicine

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