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DOES THE ADDITION OF DEXAMETHASONE TO INTERSCALENE BLOCKS AFFECT POSTOPERATIVE PAIN SCORES AND STRONG OPIOID CONSUMPTION IN DAY-CASE SHOULDER SURGERY?
Author(s): ,
Greasley, M.*
Affiliations:
Leeds teaching hospitals NHS trust, Anaesthetics, Leeds, United Kingdom
,
Hackney, H.
Affiliations:
Leeds teaching hospitals NHS trust, Anaesthetics, Leeds, United Kingdom
Gupta, P.K.
Affiliations:
Leeds teaching hospitals NHS trust, Anaesthetics, Leeds, United Kingdom
ESRA Academy. Greasley M. Sep 13, 2017; 190896; 207 Topic: Adjuvant Drugs
Dr. Mark Greasley
Dr. Mark Greasley

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Abstract
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Background and Aims:

Dexamethasone addition prolongs the duration of local anaesthetic blocks.  This studie aims to ascertain if dexamethasone addition reduces the severity of postoperative pain after block cessation and subsequent strong opioid requirements.

Methods:

Over a twelve month period, 41 patients undergoing rotator cuff repair received interscalene blocks with 0.25% bupivacaine + 3.3mg dexamethasone (Dexamethasone group, n=20) or 0.25% bupivacaine (Bupivacaine group, n=21). All patients had access to regular analgesics (paracetamol, NSAID, weak opioid) and strong opioids (oral morphine) following discharge. A telephonic survey was conducted to assess the severity of pain (scale 0 -3) and the use of opioids. 

Results:

Patients in the Dexamethasone group had lower pain scores than the Bupivacaine group after block recession (1.3 vs 2.0). A smaller percentage of patients (25%) in the Dexamethasone group used stronger opioids as compared to the Bupivacaine group (80%). Despite the reduced use of strong opioids in the Dexamethsone group, the pain score was lower after analgesia.

Conclusions:

Our study indicates that the addition of dexamethasone in some way modulates peripheral pain perception thereby reducing the magnitude of pain on block cessation and subsequent strong opioid requirements. This suggests that it may be particularly useful in day-case surgery.

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