Perineural Steroids for Peripheral Nerve Blocks

Perineural Steroids for Saphenous Peripheral Nerve Blocks: An Equivalency Dosing Study.

This study will look at the efficacy of dexamethasone for prolongation of peripheral nerve blocks.

The purpose of this randomized, double-blinded, placebo-controlled trial is to examine if dexamethasone given perineurally as an adjuvant to the nerve block will prolong the time to recovery from sensory nerve block from a saphenous (or adductor canal) nerve block. The primary outcome will be time to resolution of the nerve block as assessed by pinprick over the saphenous nerve distribution. If this primary end point is met, this study will also serve as an equivalency dosing study comparing 1 mg of perineural dexamethasone to 4 mg of perineural dexamethasone.

Inclusion Criteria:

• elective robotic medial MAKO partial knee arthroplasty
• agreed to a regional anesthesia technique

Exclusion Criteria:

• contraindications to regional anesthesia
• presence of a progressive neurological deficit
• a pre-existing coagulopathy, infection
• insulin and non-insulin dependent diabetes mellitus
• systemic use of corticosteroids within 30 days of surgery
• chronic use of an opioid analgesic (>3 months or a combined total of more than 40 mg Oxycodone equivalents a day)
• pregnancy
• a prior history of an adverse event (for example: psychosis) or an allergy to dexamethasone