Ropivacaine Block Alone or With Perineural or Systemic Dexamethasone for Pain in Shoulder Surgery

Completed · Phase 4 · Has a placebo group

Conditions studied: Shoulder Injury

In brief

Pre-operative perineural injection of dexamethasone mixed with local anesthetic in peripheral nerve blockade for orthopedic surgery has been shown to prolong the length of analgesia, improve visual analog pain scores, decrease post-operative opioid use, and decrease post-operative nausea. No study has been published to determine if this effect is a result of systemic absorption of dexamethasone or is a local effect of the drug on neuronal activity at the injection site. This study is a prospective, randomized, double-blind, controlled study to compare pain block with (1) ropivacaine and saline plus intravenous saline vs (2) ropivacaine and dexamethasone plus intravenous saline vs (3) ropivacaine and saline plus intravenous dexamethasone. Patients will be recruited sequentially and assigned to the three groups at random in equal ratios. The hypothesis is that dexamethasone injected perineurally in combination with ropivacaine for interscalene brachial plexus block will yield longer duration of sensory blockade as compared to ropivacaine alone without intravenous or perineural dexamethasone and as compared to ropivacaine and intravenous dexamethasone. This result will suggest that the effect of dexamethasone is a result of direct neuronal activity at the injection site versus systemic absorption.

Key facts

Study ID

NCT01450007

Run by

Mayo Clinic

People needed

130

Starts

2012-05-01

Expected to finish

2015-07-01

Last updated by the study team

2016-06-17

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Patients undergoing elective shoulder surgery by one of two surgeons highly experienced in the procedure.
• Patients are either: Opioid naïve; or Have not taken opiates for one month prior to surgery (tramadol is permissible).
• Patients have an American Society of Anesthesiology physical status I-III.

You may not qualify if…

• Females who are pregnant.
• Patients who are taking chronic daily opiates for one month prior to surgery except tramadol.
• Diabetic patients.
• Patients with creatinine above 1.1mg/dL for females and above 1.3mg/dL for males.
• Patients with contralateral pneumothorax or diaphragmatic paralysis.
• Patients with coagulopathy.
• Patients with clinically significant previous nerve injury in surgical extremity.
• Patients with an allergy to NSAIDs.
• Patients who are refusing a block.
• Patients with a contraindication to ropivacaine, dexamethasone, or interscalene block due to other medical condition such as severe chronic obstructive pulmonary disease (COPD).

Where it is running

• Mayo Clinic in Arizona — Phoenix, Arizona, United States

Full record on ClinicalTrials.gov

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