When compared with placebo, the duration of sensory block was prolonged in the perineural dexamethasone group by 61⁄2 half hours and in the IV dexamethasone group by 6 hours. They found the steroid can prolong the pain relief of the initial peripheral nerve block. Researchers examined 35 studies involving 2,702 patients who had upper limb surgery. Evidence suggests that administering Decadron (dexamethasone) in conjunction with the local anesthetic around the nerve (perineural) or into a vein (intravenous) may prolong the duration of a sensory block, and reduce post-op pain intensity and opioid consumption.
Here’s a simple way to possibly prolong the duration of sensory block of peripheral nerve blocks in upper limb surgery. Motor-sparing blocks are the key to this.”Ģ. “You want to get patients up and moving as quickly as possible, on the same day whenever you can. “Remember the goal is to reduce pain and increase mobility,” says Dr. Not only did those who received the injection with the blocks report significantly lower pain scores than those who only received the periarticular injection, but also they were more satisfied with their care and needed fewer opioids.
IPACK BLOCK ULTRASOUND TRIAL
The trial included 86 patients undergoing unilateral total knee arthroplasty, 43 of whom just received a periarticular injection and 43 of whom received the injection plus the 2 blocks.
Anesthesiologist David Kim, MD, of the Hospital for Special Surgery in New York City, recently studied whether combining a periarticular injection with an IPACK block and an adductor canal block would lower pain during ambulation on post-op day 1 more than just the periarticular injection alone. It’s called an IPACK block, short for interspace between the popliteal artery and capsule of the posterior knee block.
Just a short note to catch you up on the latest developments in regional anesthesia. GETTING CLOSER Advancements in ultrasound mean peripheral nerve blocks can be done further from the spinal cord and closer to where the surgery is being performed.
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