Phase 4
N=140
Intravenous Dexamethasone on Supraclavicular Brachial Plexus Block for Shoulder Arthroscopy
Shoulder Arthroscopy · Pain
Bottom Line
View on ClinicalTrials.gov: NCT02688530 ↗Enrolled (actual)
140
Serious AEs
0.0%
Results posted
May 2022
Primary outcome: Primary: Duration of Analgesia From a Supraclavicular Block Performed for Shoulder Arthroscopy — 17.4; 22.7; 20.2; 19.8 Hours
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 4
- Interventions
- IV Saline (Drug); IV Dexamethasone 4mg (Drug); IV Dexamethasone 6mg (Drug); IV Dexamethasone 8mg (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Hospital for Special Surgery, New York
- Primary completion
- Nov 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Duration of Analgesia From a Supraclavicular Block Performed for Shoulder Arthroscopy |
17.4; 22.7; 20.2; 19.8 | — |
| SECONDARY Duration of Motor Block From the Supraclavicular Block |
10.5; 19.7; 18.3; 14.7 | — |
| SECONDARY Blood Glucose Levels |
102; 108; 104; 105; 119; 122 | — |
| SECONDARY Occurrence of Postoperative Neuropraxia |
0; 1; 0; 0 | — |
| SECONDARY Occurrence of Postoperative Wound Infection |
0; 0; 0; 0 | — |
| SECONDARY Average Daily Pain Scores at Rest and With Movement |
2.6; 3; 2.4; 2.5; 0.4; 0.2 | — |
| SECONDARY Worst Daily Pain Scores at Rest and With Movement |
3.4; 3.3; 3.4; 3.6; 0.6; 0.2 | — |
| SECONDARY Patient Satisfaction With Postoperative Analgesia |
9.1; 8.9; 9.2; 8.7 | — |
| SECONDARY Cumulative Daily Opioid Usage |
31; 30.5; 30.7; 31.3; 22.3; 27.4 | — |
Summary
Previous studies have confirmed that IV dexamethasone prolongs brachial plexus blocks. However, these studies only used fixed doses of IV dexamethasone at relatively high doses, which could potentially lead to increased glucose levels, delayed wound healing, and unintended side effects. There remains a paucity of research on the effective dose range of IV dexamethasone for the prolongation of supraclavicular blocks. The optimal dosage of IV dexamethasone for prolongation of analgesia vs. motor block prolongation from supraclavicular blocks in shoulder surgery has yet to be delineated.
Eligibility Criteria
Inclusion Criteria
- Patients undergoing shoulder arthroscopy under regional anesthesia
Exclusion Criteria
- General anesthesia
- Contraindication to regional anesthesia
- Pre-existing neuropathy in the surgical limb
- Diabetes Mellitus
- History of postoperative nausea and vomiting &/ or motion sickness
- Procedures involving biceps tenotomy
- Peri-articular cocktail injections given intraoperatively to augment pain relief
- Chronic pain (daily opioid and/or gabapentinoid use for 6 weeks)
- Open surgical procedures
- Corticosteroid injection within 1 month
- Patients on systemic oral or IV steroid therapy within 6 months
Data sourced from ClinicalTrials.gov (NCT02688530). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.