Intravenous injection of dexamethasone is non-inferior to perineural administration for popliteal sciatic nerve and saphenous nerve blocks: A randomized, controlled, triple-blind study

• Published in: Heliyon 2024-04, Vol.10 (7), p.e28304-e28304, Article e28304
• Main Authors: Lei, Guiyu, Yang, Siliu, Wu, Lili, Yin, Yue, Zhang, Shu, Wang, Guyan
• Format: Article
• Language: English
• Subjects: Dexamethasone; Foot and ankle surgery; Intravenous; Nerve block; Perineural
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2024.e28304

The aim of this study was to assess whether intravenous dexamethasone was noninferior to perineural dexamethasone as an adjuvant to ropivacaine for a combination of saphenous and sciatic nerve blocks in patients undergoing foot and ankle surgery. This was a prospective, blinded, randomized noninferiority study. Seventy-five patients, aged 18–75 years, with an American Society of Anesthesiologists (ASA) physical status I-III who underwent foot and ankle surgery were involved. Patients scheduled for ultrasound-guided popliteal sciatic nerve block and saphenous nerve block were randomized to receive 0.375% ropivacaine with 7.5 mg of dexamethasone perineurally (Dex-PN), 10 mg of dexamethasone intravenously (Dex-IV) or neither (Placebo). The primary outcome was the duration of analgesia. The major secondary outcomes were the composite pain intensity and opioid consumption score at 0–48 h intervals after anesthesia. The mean analgesic duration was 26.2 h in the Dex-IV group and 27.9 h in the Dex-PN group (duration difference, −1.7; 95% CI, −3.8 to 0.43; P = 0.117), and both durations were significantly longer than that in the placebo group (17.6 h, P