Distal Radius Fracture, Post Operative Pain
Conditions
Brief summary
The addition of the steroid dexamethasone to a single injection of local anesthetic has been shown to significantly prolong the duration of peripheral nerve blockade compared to local anesthetic alone. This allows for improved post-operative pain scores and reduces opioid use in the early post-operative period. However, the use of a steroid adjuvant in regional nerve blocks is generally not considered standard of care, and there is considerable variation among anesthesiologists regarding preferred formulations and the role of adjuvants in regional anesthesia. A recent study from our institution demonstrated the effectiveness of dexamethasone directly mixed with local anesthetic at multiple doses compared to placebo for upper extremity surgery. With this prospective randomized controlled blinded trial, we hope to definitively establish which method of adjuvant dexamethasone administration is superior in extending the effects of a brachial plexus nerve block.
Interventions
DRUGDexamethasone 4mg
4 mg of Dexamethasone will be given before surgery
DRUGRopivacaine
Ultrasound guided supraclavicular block with ropivacaine will be given to patients before surgery
Sponsors
Rothman Institute Orthopaedics
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients over the age of 18 undergoing open reduction and internal fixation of a distal radius fracture less than 3 weeks from injury with a volar plate technique * American Society of Anesthesiologists (ASA) levels 1 through 3 at time of surgery * Opioid naïve patients
Exclusion criteria
* History of Drug/opioid/alcohol abuse * Polytrauma patients * History of inflammatory disorder, infection, dementia, psychiatric/neurological disorder, relevant drug/local anesthesia allergy, relevant chronic upper extremity pain (RSD, fibromyalgia, neuralgia, etc) * Excessive BMI * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative pain control | 72 hours | Measured using participants Visual Analog Scale (VAS) pain scores |
| Postoperative pain control #2 questionnaire | 72 hours | Measured by asking participants how much medication they take after surgery to help control their pain |
Countries
United States
Outcome results
None listed