PDF(Pubmed)
Abstract：
UNASSIGNED: Glucocorticoids are commonly utilised as adjuvants to enhance nerve block quality and prolong the analgesic duration. Its systemic effects, after a single-injection adductor canal block (ACB) followed by a continuous infusion, are unclear. The aim of the study was to assess the systemic effects of a single dose of dexamethasone sodium phosphate (DEX), or a combination of DEX and methylprednisolone acetate (MPA), on fasting blood glucose (FBG) and white blood cell count (WBC) when administered perineurally via ACB.
UNASSIGNED: A single-center retrospective study on total knee arthroplasty (TKA) was performed and a total of 95 patients were included in the final analysis. Patients were divided into three groups based on adjuvants received in ACB: Control group (N = 41) and two treatment groups, DEX group (N = 33) and DEX/MPA group (N = 21). Our primary outcomes were the change of FBG from its preoperative baseline value on postoperative day (POD) 2. The secondary outcomes included change of FBG on POD 0 and POD 1, and change of WBC on POD 0, POD 1, and POD 2.
UNASSIGNED: The FBG change from baseline in the DEX group was significantly higher than that in the control group (difference = 14.04, 95% CI: 1.3 to 26.77), P = 0.031) on POD 0. The WBC change from baseline in the DEX/MPA group was statistically significant higher than control on POD 0 (2.62 (1.52 to 3.37), P < 0.0001). No significant differences between DEX and DEX/MPA group were found on any given postoperative days for FBG and WBC.
UNASSIGNED: This study provided preliminary safety data on the use of a combination of glucocorticoids with hydrophilic (DEX) and lipophilic (MPA) properties as local anesthetic adjuvants in ACB, which induced similar levels of changes on FBG and WBC as those from both control and DEX alone group.
UNASSIGNED: A single-center retrospective study on total knee arthroplasty (TKA) was performed and a total of 95 patients were included in the final analysis. Patients were divided into three groups based on adjuvants received in ACB: Control group (N = 41) and two treatment groups, DEX group (N = 33) and DEX/MPA group (N = 21). Our primary outcomes were the change of FBG from its preoperative baseline value on postoperative day (POD) 2. The secondary outcomes included change of FBG on POD 0 and POD 1, and change of WBC on POD 0, POD 1, and POD 2.
UNASSIGNED: The FBG change from baseline in the DEX group was significantly higher than that in the control group (difference = 14.04, 95% CI: 1.3 to 26.77), P = 0.031) on POD 0. The WBC change from baseline in the DEX/MPA group was statistically significant higher than control on POD 0 (2.62 (1.52 to 3.37), P < 0.0001). No significant differences between DEX and DEX/MPA group were found on any given postoperative days for FBG and WBC.
UNASSIGNED: This study provided preliminary safety data on the use of a combination of glucocorticoids with hydrophilic (DEX) and lipophilic (MPA) properties as local anesthetic adjuvants in ACB, which induced similar levels of changes on FBG and WBC as those from both control and DEX alone group.
摘要：
糖皮质激素通常用作佐剂以增强神经阻滞质量并延长镇痛持续时间。它的系统性影响，在单次注射内收肌管阻滞（ACB），然后连续输注后，不清楚。该研究的目的是评估单剂量地塞米松磷酸钠（DEX）的全身效应，或DEX和醋酸甲基强的松龙（MPA）的组合，通过ACB在神经周围给药时对空腹血糖（FBG）和白细胞计数（WBC）的影响。
■进行了一项关于全膝关节置换术（TKA）的单中心回顾性研究，最终分析共包括95例患者。根据ACB中接受的佐剂将患者分为三组：对照组（N=41）和两个治疗组，DEX组(N=33)和DEX/MPA组(N=21)。我们的主要结果是术后第2天FBG从术前基线值的变化（POD）。次要结果包括POD0和POD1上FBG的变化，以及POD0，POD1和POD2上WBC的变化。
■DEX组自基线的FBG变化显着高于对照组（差异=14.04，95％CI：1.3至26.77），P=0.031)对POD0。DEX/MPA组自基线的WBC变化在POD0上显著高于对照组(2.62(1.52至3.37),P<0.0001)。在任何给定的术后天数，DEX和DEX/MPA组之间的FBG和WBC均无显着差异。
■这项研究提供了有关在ACB中使用具有亲水性（DEX）和亲脂性（MPA）特性的糖皮质激素组合作为局部麻醉佐剂的初步安全性数据，与对照组和单独的DEX组相比，FBG和WBC的变化水平相似。
■进行了一项关于全膝关节置换术（TKA）的单中心回顾性研究，最终分析共包括95例患者。根据ACB中接受的佐剂将患者分为三组：对照组（N=41）和两个治疗组，DEX组(N=33)和DEX/MPA组(N=21)。我们的主要结果是术后第2天FBG从术前基线值的变化（POD）。次要结果包括POD0和POD1上FBG的变化，以及POD0，POD1和POD2上WBC的变化。
■DEX组自基线的FBG变化显着高于对照组（差异=14.04，95％CI：1.3至26.77），P=0.031)对POD0。DEX/MPA组自基线的WBC变化在POD0上显著高于对照组(2.62(1.52至3.37),P<0.0001)。在任何给定的术后天数，DEX和DEX/MPA组之间的FBG和WBC均无显着差异。
■这项研究提供了有关在ACB中使用具有亲水性（DEX）和亲脂性（MPA）特性的糖皮质激素组合作为局部麻醉佐剂的初步安全性数据，与对照组和单独的DEX组相比，FBG和WBC的变化水平相似。
