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Title

Comparison of Dexmedetomidine and Dexamethasone as Adjuvants to Ultra-Sound Guided Interscalene Block in Arthroscopic Shoulder Surgery: A Double-Blinded Randomized Placebo-Controlled Study

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Abstract

 Background: Interscalene block is one of the popular methods for decreasing pain and analgesic consumption after shoulder arthroscopic surgeries. Objectives: The objective is to compare the analgesic duration of eff ects of Dexmedetomidine and Dexamethasone as adjuvants to 0. 5% ropivacaine in ultrasound-guided interscalene blocks for arthroscopic shoulder surgery in an ambulatory setting. Methods: In this randomized controlled trial, 117 adult patients candidate for ambulatory arthroscopic shoulder surgery under general anesthesia were divided into three groups to perform an ultra-sound guided interscalene block before the surgery. The ropivacaine (control) group received ropivacaine 0. 5% 20 mL, group Dexamethasone received ropivacaine 0. 5% 20 mL plus 4mg Dexamethasone, and group Dexmedetomidine received ropivacaine 0. 5% 20 mL plus 75 mcg of Dexmedetomidine. Time to return of sensory function, of motor function, of fi rst pain sensation, amount of opioid medication consumed at 24 hours and 48 hours post-operatively were measured. Results: The 24-hour median (25th-75th percentile) opioid consumption in morphine equivalents was similar between groups 22. 5 mg (10-30), 15 mg (0-30), and 15 mg (0-20. 6) in the ropivacaine, Dexmedetomidine, and Dexamethasone groups, respectively (P = 0. 130). The median (25th-75th percentile) 48 hours post-operatively, the median opioid consumption in morphine equivalents was 40 mg (25-67. 5) in the ropivacaine group, 30 mg (22-50. 6) in the Dexamethasone group, and 52. 5 mg (30-75) in the Dexmedetomidine group (P = 0. 278). The median 24-hour pain scores were 6 (5-8) in the ropivacaine control group, 7 (5. 5-8) in the Dexamethasone group, and 7 (4-9) in the Dexmedetomidine group (P = 0. 573). Conclusions: There was no statistical diff erence in opioid consumption at 24 and 48 hours post-operatively when comparing Dexmedetomidine, Dexamethasone, and no adjuvant. However, intraoperative opioid use was signifi cantly lower with Dexmedetomidine compared to Dexamethasone and plain 0. 5% ropivacaine. The safe side eff ect profi le of Dexmedetomidine makes it a reasonable alternative as an adjuvant for peripheral nerve blockade when Dexamethasone use may be contraindicated.

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    APA: Copy

    Margulis, Roman, Francis, Jacquelyn, Tischenkel, Bryan, Bromberg, Adam, Pedulla, Domenic, Grtisenko, Karina, Cornett, Elyse M., KAYE, ALAN DAVID, IMANI, FARNAD, IMANI, FARSAD, Shaparin, Naum, & Vydyanathan, Amaresh. (2021). Comparison of Dexmedetomidine and Dexamethasone as Adjuvants to Ultra-Sound Guided Interscalene Block in Arthroscopic Shoulder Surgery: A Double-Blinded Randomized Placebo-Controlled Study. ANESTHESIOLOGY AND PAIN MEDICINE, 11(3), 0-0. SID. https://sid.ir/paper/668440/en

    Vancouver: Copy

    Margulis Roman, Francis Jacquelyn, Tischenkel Bryan, Bromberg Adam, Pedulla Domenic, Grtisenko Karina, Cornett Elyse M., KAYE ALAN DAVID, IMANI FARNAD, IMANI FARSAD, Shaparin Naum, Vydyanathan Amaresh. Comparison of Dexmedetomidine and Dexamethasone as Adjuvants to Ultra-Sound Guided Interscalene Block in Arthroscopic Shoulder Surgery: A Double-Blinded Randomized Placebo-Controlled Study. ANESTHESIOLOGY AND PAIN MEDICINE[Internet]. 2021;11(3):0-0. Available from: https://sid.ir/paper/668440/en

    IEEE: Copy

    Roman Margulis, Jacquelyn Francis, Bryan Tischenkel, Adam Bromberg, Domenic Pedulla, Karina Grtisenko, Elyse M. Cornett, ALAN DAVID KAYE, FARNAD IMANI, FARSAD IMANI, Naum Shaparin, and Amaresh Vydyanathan, “Comparison of Dexmedetomidine and Dexamethasone as Adjuvants to Ultra-Sound Guided Interscalene Block in Arthroscopic Shoulder Surgery: A Double-Blinded Randomized Placebo-Controlled Study,” ANESTHESIOLOGY AND PAIN MEDICINE, vol. 11, no. 3, pp. 0–0, 2021, [Online]. Available: https://sid.ir/paper/668440/en

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