Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Austria.
Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Austria.
J Clin Anesth. 2022 May;77:110622. doi: 10.1016/j.jclinane.2021.110622. Epub 2021 Dec 3.
Dexamethasone is commonly used as an adjuvant to local anesthetics to prolong duration of peripheral nerve blocks with minimal side-effects. The present study investigates the efficacy of dexamethasone added to ropivacaine 0.2% as compared to ropivacaine 0.2% alone for pectoral nerves block II (PECS II) in unilateral radical mastectomy.
A prospective, randomized, controlled and double-blinded trial.
The study was performed at Innsbruck Medical University Hospital, Austria, between January 2019 and October 2020.
Sixty female patients with an American Society of Anesthesiologists Score I-II (18-90 years, BMI 18-35) scheduled for unilateral radical mastectomy without one-stage immediate autologous breast reconstruction were randomly assigned to receive PECS II block with ropivacaine 0.2% with or without dexamethasone 8 mg.
Patients were randomly assigned to receive PECS II block with ropivacaine 0.2% with or without dexamethasone 8 mg.
Primary outcome parameter was the cumulative opioid consumption during the first 72 postoperative hours. Secondary outcome parameters were the duration of analgesia and the course of the visual analogue scale (VAS) and the area under the curve VAS (AUC-VAS).
There was no difference in cumulative opioid consumption after 72 h between the ropivacaine 0.2% plus dexamethasone group and the ropivacaine 0.2% plus placebo group (11.89 vs 11.90 morphine milligram equivalent, respectively; p 0.831). Duration of analgesia also did not differ significantly between the ropivacaine 0.2% plus dexamethasone group and the ropivacaine 0.2% plus placebo group (12.75 versus 8.75 h, respectively; p 0.680). There also was no difference in the course of VAS and AUC-VAS.
Dexamethasone 8 mg when added to ropivacaine 0.2% for PECS II block in unilateral radical mastectomy was not found to reduce total opioid consumption over 72 postoperative hours or to prolong duration of analgesia as compared to pure ropivacaine 0.2%.
地塞米松常被用作局部麻醉剂的辅助药物，以延长周围神经阻滞的持续时间，同时最小化副作用。本研究旨在比较罗哌卡因 0.2% 中加入地塞米松与单纯使用罗哌卡因 0.2% 对乳腺癌根治术第二肋间神经阻滞（PECTS II）的效果。
前瞻性、随机、对照、双盲试验。
本研究于 2019 年 1 月至 2020 年 10 月在奥地利因斯布鲁克医科大学医院进行。
60 名美国麻醉医师协会评分 I-II 级（18-90 岁，BMI 18-35）的女性患者，拟行单侧乳腺癌根治术，不进行一期即刻自体乳房重建，随机分为罗哌卡因 0.2% 联合地塞米松 8mg 或罗哌卡因 0.2% 行 PECTS II 阻滞。
患者随机分为罗哌卡因 0.2% 联合地塞米松 8mg 或罗哌卡因 0.2% 行 PECTS II 阻滞。
主要观察指标为术后 72 小时内累积阿片类药物消耗量。次要观察指标为镇痛持续时间和视觉模拟评分（VAS）及曲线下面积 VAS（AUC-VAS）的变化。
罗哌卡因 0.2% 联合地塞米松组和罗哌卡因 0.2% 联合安慰剂组在术后 72 小时内累积阿片类药物消耗量无显著差异（分别为 11.89 与 11.90 吗啡毫克当量，p=0.831）。罗哌卡因 0.2% 联合地塞米松组和罗哌卡因 0.2% 联合安慰剂组镇痛持续时间也无显著差异（分别为 12.75 与 8.75 小时，p=0.680）。VAS 和 AUC-VAS 也无差异。
在单侧乳腺癌根治术中，罗哌卡因 0.2% 中加入 8mg 地塞米松并未发现与单纯使用罗哌卡因 0.2% 相比，在术后 72 小时内减少总阿片类药物消耗量或延长镇痛持续时间。
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