PDF(Pubmed)
Abstract：
UNASSIGNED: The purpose of this study is to determine if using a combination of dexamethasone and dexmedetomidine (Dex-Dex) in a single-shot perineural local anesthestic provides an increased duration of pain relief and reduced consumption of opioids for patients undergoing shoulder surgery.
UNASSIGNED: This is a retrospective trial of adult patients without major comorbidities undergoing elective, upper arm orthopedic procedures with regional nerve block for post-operative analgesia. Patients underwent nerve block with either 0.5% ropivacaine or 0.2% ropivacaine with 5mg dexamethasone and 25mg dexmedetomidine (\"dex-dex\"). Patients were assessed in 1-week intervals for two weeks for duration of block analgesia, pain scores, and opioid use.
UNASSIGNED: 31 patients were included, 12 controls and 19 in the dex-dex group. These patients underwent one of arthroscopic rotator cuff repair, reverse total shoulder repair or repair of humerus fractures. Dex-dex blocks provided significantly longer analgesia (median block time 3.5 versus 1.5 days, p<0.0001), significantly better analgesia (mean NRS 2.32 versus 8.58 on post-operative day 1, p<0.0001), and significantly reduced opioid requirements (108.16mg vs 275.63mg in MME, p<0.0001). One patient experienced transient hypotension and prolonged paresthesia in the dex-dex group.
UNASSIGNED: Preoperative single-shot interscalene nerve blocks with preservative-free dexamethasone and dexmedetomidine added as adjuvants to ropivicaine provide approximately two additional days of benefit versus ropivicaine alone. Additionally, postoperative opioid consumption is reduced.
UNASSIGNED: This is a retrospective trial of adult patients without major comorbidities undergoing elective, upper arm orthopedic procedures with regional nerve block for post-operative analgesia. Patients underwent nerve block with either 0.5% ropivacaine or 0.2% ropivacaine with 5mg dexamethasone and 25mg dexmedetomidine (\"dex-dex\"). Patients were assessed in 1-week intervals for two weeks for duration of block analgesia, pain scores, and opioid use.
UNASSIGNED: 31 patients were included, 12 controls and 19 in the dex-dex group. These patients underwent one of arthroscopic rotator cuff repair, reverse total shoulder repair or repair of humerus fractures. Dex-dex blocks provided significantly longer analgesia (median block time 3.5 versus 1.5 days, p<0.0001), significantly better analgesia (mean NRS 2.32 versus 8.58 on post-operative day 1, p<0.0001), and significantly reduced opioid requirements (108.16mg vs 275.63mg in MME, p<0.0001). One patient experienced transient hypotension and prolonged paresthesia in the dex-dex group.
UNASSIGNED: Preoperative single-shot interscalene nerve blocks with preservative-free dexamethasone and dexmedetomidine added as adjuvants to ropivicaine provide approximately two additional days of benefit versus ropivicaine alone. Additionally, postoperative opioid consumption is reduced.
摘要：
■这项研究的目的是确定在单次注射神经周局部麻醉中使用地塞米松和右美托咪定（Dex-Dex）的组合是否可以延长疼痛缓解持续时间并减少阿片类药物的消耗用于接受肩部手术的患者。
■这是一项对没有重大合并症的成年患者进行的回顾性试验，局部神经阻滞用于术后镇痛的上臂骨科手术。患者接受0.5％罗哌卡因或0.2％罗哌卡因联合5mg地塞米松和25mg右美托咪定的神经阻滞（“dex-dex”）。以1周的间隔对患者进行了为期两周的阻滞镇痛评估，疼痛评分,和阿片类药物的使用。
■包括31名患者，dex-dex组中有12个对照和19个对照。这些患者接受了关节镜肩袖修复术，反向全肩关节修复或肱骨骨折修复。Dex-dex阻滞提供了明显更长的镇痛(中位阻滞时间3.5天对1.5天,p<0.0001),镇痛效果明显更好（术后第1天平均NRS2.32vs8.58，p<0.0001），并显着降低了阿片类药物的需求（MME中108.16mg对275.63mg，p<0.0001)。dex-dex组一名患者出现短暂性低血压和长时间感觉异常。
■术前一次性肌间沟神经阻滞与不含防腐剂的地塞米松和右美托咪定作为佐剂添加到罗哌卡因中相比单独使用罗哌卡因可额外提供约2天的益处。此外,术后阿片类药物的消耗减少。
■这是一项对没有重大合并症的成年患者进行的回顾性试验，局部神经阻滞用于术后镇痛的上臂骨科手术。患者接受0.5％罗哌卡因或0.2％罗哌卡因联合5mg地塞米松和25mg右美托咪定的神经阻滞（“dex-dex”）。以1周的间隔对患者进行了为期两周的阻滞镇痛评估，疼痛评分,和阿片类药物的使用。
■包括31名患者，dex-dex组中有12个对照和19个对照。这些患者接受了关节镜肩袖修复术，反向全肩关节修复或肱骨骨折修复。Dex-dex阻滞提供了明显更长的镇痛(中位阻滞时间3.5天对1.5天,p<0.0001),镇痛效果明显更好（术后第1天平均NRS2.32vs8.58，p<0.0001），并显着降低了阿片类药物的需求（MME中108.16mg对275.63mg，p<0.0001)。dex-dex组一名患者出现短暂性低血压和长时间感觉异常。
■术前一次性肌间沟神经阻滞与不含防腐剂的地塞米松和右美托咪定作为佐剂添加到罗哌卡因中相比单独使用罗哌卡因可额外提供约2天的益处。此外,术后阿片类药物的消耗减少。
