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REGIONAL ANESTHESIA

Does Dexamethasone Improve the Quality of Intravenous Regional Anesthesia and Analgesia? A Randomized, Controlled Clinical Study

Department of Anesthesiology, Akdeniz University Medical Faculty, Antalya, Turkey

Address correspondence and reprint requests to Zekiye Bigat, MD, Akdeniz University Medical Faculty, Department of Anesthesiology, 07070 Antalya, Turkey. Address e-mail to zekiyebigat{at}hotmail.com.

We investigated the anesthetic and analgesic effectiveness of adding dexamethasone to lidocaine for IV regional anesthesia (IVRA). Seventy-five patients undergoing ambulatory hand surgery were randomly assigned to one of three groups: group L received 3 mg/kg lidocaine, group LD received 3 mg/kg lidocaine + 8 mg dexamethasone, and group LDc received 3 mg/kg lidocaine for IVRA and 8 mg dexamethasone IV to the nonsurgical arm. IVRA was established using 40 mL of a solution. Visual analog scale and verbal pain scores were recorded intraoperatively and for 2 h postoperatively. Postoperative pain was treated with oral acetaminophen 500 mg every 4 h when visual analog scale score was more than 3. Time to request for the first analgesic and the total dose in the first 24 h were noted. Times to onset of complete sensory and motor block were similar in the 3 groups. The times to recovery of motor block (L = 8 [5.91–10.08] min, LD = 13 [6.76–20.19] min, LDc = 6 [4.44–8.43] min) and sensory block (L = 7 [5.21–10.30] min, LD = 12 [6.11–19.40] min and LDc = 6 [4.2–8.11] min) were longer in group LD (P < 0.05). Patients in group LD reported significantly lower pain scores and required less acetaminophen in the first 24 h after surgery. In conclusion, the addition of 8 mg dexamethasone to lidocaine for IVRA in patients undergoing hand surgery improves postoperative analgesia during the first postoperative day.