Tang Qianqian, Gao Shihui, Wang Changming, Yan Zenglong, Zhang Jing
Department of Anesthesiology, People's Hospital of China Medical University (People's Hospital of Liaoning Province), Shenyang, China.
Department of Anesthesiology, Liaoning Electric Power Central Hospital, Shenyang, China.
Clin J Pain. 2025 Sep 1;41(9):e1301. doi: 10.1097/AJP.0000000000001301.
Interscalene brachial plexus block (ISBPB) has gained popularity as a pain-relief method following shoulder arthroscopic surgery, significantly reducing the need for analgesics. This study was designed to evaluate whether the addition of dexamethasone to different effective concentrations of ropivacaine in ultrasound-guided ISBPB affects postoperative analgesic effect in patients undergoing shoulder arthroscopy surgery.
A total of 140 participants elected for shoulder arthroscopy under ISBPB and general anesthesia, randomized into 6 equal groups. Group A, B, and C received 10 mL 0.25%, 0.5%, and 0.75% ropivacaine mixed with 1 mL 0.9% saline, respectively. Likewise, groups A1, B1, and C1 received the same volumes of ropivacaine with 5 mg dexamethasone. The primary goal was to assess the duration of analgesia with ISBPB, with secondary objectives concerning postoperative nausea and vomiting (PONV) and numerical rating scale (NRS) pain scores.
Across a range of ropivacaine concentrations, there was no significant difference in the analgesic efficacy between participants receiving dexamethasone treatment and those who did not. Notably, there was no demonstrable difference in the duration of analgesia among the treatment groups (group A vs. group A1: 510.13±262.39 min, 518.21±395.49 min; P =0.054); (group B vs. group B1: 672.42±306.63 min, 646.05±348.48 min; P =0.281); (group C vs. group C1: 724.42±384.14 min, 680.29±414.30 min; P =0.782). Furthermore, there was no significant difference in the incidence of intraoperative and postoperative complications.
The present study indicated that the addition of dexamethasone to ropivacaine did not appear to provide any additional advantages in postoperative analgesic efficacy compared with the use of ropivacaine alone for patients undergoing shoulder arthroscopy surgery with ISBPB.
肌间沟臂丛神经阻滞（ISBPB）作为肩关节镜手术后的一种镇痛方法已受到广泛欢迎，显著减少了镇痛药的使用需求。本研究旨在评估在超声引导下的ISBPB中，向不同有效浓度的罗哌卡因中添加地塞米松是否会影响接受肩关节镜手术患者的术后镇痛效果。
共有140名选择在ISBPB联合全身麻醉下进行肩关节镜手术的参与者，随机分为6个相等的组。A组、B组和C组分别接受10 mL 0.25%、0.5%和0.75%的罗哌卡因与1 mL 0.9%生理盐水混合液。同样，A1组、B1组和C1组接受相同体积的含5 mg地塞米松的罗哌卡因。主要目标是评估ISBPB的镇痛持续时间，次要目标包括术后恶心呕吐（PONV）和数字评分量表（NRS）疼痛评分。
在一系列罗哌卡因浓度范围内，接受地塞米松治疗的参与者与未接受治疗的参与者在镇痛效果上没有显著差异。值得注意的是，各治疗组之间在镇痛持续时间上没有明显差异（A组与A1组：510.13±262.39分钟，518.21±395.49分钟；P = 0.054）；（B组与B1组：672.42±306.63分钟，646.05±348.48分钟；P = 0.281）；（C组与C1组：724.42±384.14分钟，680.29±414.30分钟；P = 0.782）。此外，术中及术后并发症的发生率没有显著差异。
本研究表明，对于接受ISBPB的肩关节镜手术患者，与单独使用罗哌卡因相比，在罗哌卡因中添加地塞米松在术后镇痛效果上似乎没有提供任何额外优势。
