A randomised controlled trial of intravenous dexmedetomidine added to dexamethasone for arthroscopic rotator cuff repair and duration of interscalene block.

Détails

ID Serval
serval:BIB_5337232B8B0A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
A randomised controlled trial of intravenous dexmedetomidine added to dexamethasone for arthroscopic rotator cuff repair and duration of interscalene block.
Périodique
Anaesthesia
Auteur⸱e⸱s
Albrecht E., Capel D., Rossel J.B., Wolmarans M.R., Godenèche A., De Paulis D., Cabaton J.
ISSN
1365-2044 (Electronic)
ISSN-L
0003-2409
Statut éditorial
Publié
Date de publication
03/2023
Peer-reviewed
Oui
Volume
78
Numéro
3
Pages
315-319
Langue
anglais
Notes
Publication types: Randomized Controlled Trial ; Journal Article
Publication Status: ppublish
Résumé
Prolongation of peripheral nerve blockade by intravenous dexamethasone may be extended by intravenous dexmedetomidine. We randomly allocated 122 participants who had intravenous dexamethasone 0.15 mg.kg <sup>-1</sup> before interscalene brachial plexus block for day-case arthroscopic rotator cuff repair to intravenous saline (62 participants) or intravenous dexmedetomidine 1 μg.kg <sup>-1</sup> (60 participants). The primary outcome was time from block to first oral morphine intake during the first 48 postoperative hours. Fifty-nine participants reported taking oral morphine, 25/62 after placebo and 34/60 after dexmedetomidine, p = 0.10. The time to morphine intake was shorter after dexmedetomidine, hazard ratio (95%CI) 1.68 (1.00-2.82), p = 0.049. Median (IQR [range]) morphine doses were 0 (0-12.5 [0-50]) mg after control vs. 10 (0-30 [0-50]) after dexmedetomidine, a difference (95%CI) of 7 (0-10) mg, p = 0.056. There was no effect of dexmedetomidine on pain at rest or on movement. Intra-operative hypotension was recorded for 27/62 and 50/60 participants after placebo vs. dexmedetomidine, respectively, p < 0.001. Other outcomes were similar, including durations of sensory and motor block. In conclusion, dexmedetomidine shortened the time to oral morphine consumption after interscalene block combined with dexamethasone and caused intra-operative hypotension.
Mots-clé
Humans, Brachial Plexus Block, Dexmedetomidine, Rotator Cuff/surgery, Pain, Postoperative/drug therapy, Pain, Postoperative/prevention & control, Morphine, Dexamethasone, Hypotension, Anesthetics, Local, Arthroscopy, local anaesthetic adjuncts, peripheral nerve block, postoperative analgesia, regional anaesthesia
Pubmed
Web of science
Open Access
Oui
Création de la notice
19/12/2022 11:05
Dernière modification de la notice
16/11/2023 8:11
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