None listed
Conditions
Brief summary
Epidural dexamethasone has been used for many years as a treatment for lower back pain and more recently for postoperative analgesia. Favourable results have also been demonstrated when dexamethasone is added to bupivacaine for interscalene nerve block: the time to first onset of operative site pain increased from 12 to 20 hours. However, perineural dexamethasone has not been studied when added to bupivacaine for lower limb peripheral nerve block. The main limitation of the lower limb block for postoperative analgesia is its limited duration of effect; therefore, any therapeutic intervention effective in prolonging lower limb block duration has clinical value. The primary aim of this study therefore is to test the hypothesis that the addition of dexamethasone 8 mg to 30 mL bupivacaine 0.5% administered via lower limb block will prolong the time to first pain after foot and ankle surgery conducted under general anaesthesia.
Interventions
Dexamethasone Group
A single operator will place all blocks in the operating room. Patients will be premedicated with oral acetaminophen 1 g one hour before surgery. Intravenous midazolam 2 mg, alfentanil 0.5 mg will be administered 5 min prior the establishment of general anaesthesia. A standardised lower limb block will be administered using standard landmarks. Patients will receive (using a computerised random number generator) 30 mL of bupivacaine 0.5% to which 2 ml of dexamethasone 8 mg wil
Dexamethasone Group A single operator will place all blocks in the operating room. Patients will be premedicated with oral acetaminophen 1 g one hour before surgery. Intravenous midazolam 2 mg, alfentanil 0.5 mg will be administered 5 min prior the establishment of general anaesthesia. A standardised lower limb block will be administered using standard landmarks. Patients will receive (using a computerised random number generator) 30 mL of bupivacaine 0.5% to which 2 ml of dexamethasone 8 mg will be added. Patients will receive a 2 ml intramuscular injection of 0.9% saline.
Sponsors
Dr Michael Fredrickson
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
16 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Patients requiring surgical anaesthesia for foot/ankle surgery under the care of the principal and co-investigators.
Exclusion criteria
Exclusion criteria will include patient refusal for lower limb block, known neuropathy involving the limb undergoing surgery, and known allergy to amide local anaesthetic drugs.
Outcome results
None listed