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Effect of systematic dexamethasone on the duration of popliteal nerve block after pediatric ankle/foot surgery
This study is proposed to explore the effect of systemic dexamethasone on the duration of popliteal nerve block for analgesia after pediatric ankle surgery.
After ankle or foot surgery, children need good analgesia. Peripheral nerve blocks have provided a safe, effective method to control early postoperative pain when symptoms are most severe.
The safety of local anesthesia is particularly important in children due to the much lower toxicity threshold of local anesthetics. The use of an effective adjuvant, such as Dexamethasone, could allow for the use of a higher dilution of local anesthetics while maintaining and enhancing their analgesic effect.
There is multiple research where intravenous and perineural dexamethasone use has been compared in adults. However, there is a huge lack of research regarding children.
In this study, investigators compare different doses of systemic dexamethasone. Before the anesthesia, the patients receive dexamethasone intravenously. Groups 2 and 3 have dexamethasone doses of 0.1mg/kg, and 0.2mg/kg.
The investigator's goal is to find a dexamethasone dose that is as low as possible but at the same time covers the need for good pain relief and fast recovery postoperatively.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| placebo injection | Active Comparator | 5ml of 0,9% sodium chloride - before the popliteal nerve block |
|
| 0,1mg/kg Dexamethasone | Active Comparator | 0,1mg/kg dexamethasone sodium phosphate - before the popliteal nerve block |
|
| 0,2mg/kg Dexamethasone | Active Comparator | 0,2mg/kg dexamethasone sodium phosphate - before the popliteal nerve block |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sodium Chloride 0.9% Inj | Drug | administration of 5ml 0,9% sodium chloride - 30 minutes before the popliteal nerve block |
|
| Measure | Description | Time Frame |
|---|---|---|
| first need of opiate | Time after surgery when the patient needs opiate for the first time | 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Opioid Consumption | Total opiate consumption after surgery | 48 hours |
| Pain score | children <3years old FLACC score (Face, Legs, Activity, Cry, Consolability) children >3years old NRS (Numerical Rating Scale) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tomasz Kotwicki, Prof.dr hab. | Poznań University of Medical Sciences | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Spine Diseases and Pediatric Orthopedics, University of Medical Sciences, Poznań, Poland | Poznan | Wielkopolska | 61-545 | Poland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41352236 | Derived | Reysner T, Ciftci B, Pietraszek P, Purat T, Shadi M, Musielak B, Idzior M, Daroszewski P, Reysner M. Effect of intravenous dexamethasone on duration of analgesia following popliteal nerve block in pediatric ankle surgery: A randomized, triple-blinded clinical trial. J Clin Anesth. 2026 Feb;109:112094. doi: 10.1016/j.jclinane.2025.112094. Epub 2025 Dec 5. |
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| 0,1mg/kg Dexamethasone | Drug | administration of 0,1mg/kg Dexamethasone - 30 minutes before the popliteal nerve block |
|
|
| 0,2mg/kg Dexamethasone | Drug | administration of 0,2mg/kg Dexamethasone - 30 minutes before the popliteal nerve block |
|
|
| 4 hours, 8 hours, 12 hours, 16 hours, 18 hours, 24 hours, 28 hours, 32 hours, 36 hours, 40 hours, 44 hours, 48 hours after surgery |
| Blood glucose | Blood glucose every 24 hour during hospitalization | 24 and 48 hours after surgery |
| NLR | Neutrophil-to-lymphocyte ratio | 24 and 48 hours after surgery |
| PLR | Platelet-to-lymphocyte ratio | 24 and 48 hours after surgery |
| Mobilisation | Toe movement every 4 hours | 4 hours, 8 hours, 12 hours, 16 hours, 18 hours, 24 hours, 28 hours, 32 hours, 36 hours, 40 hours, 44 hours, 48 hours after surgery |
| Poznan Univesity of Medical Sciences | Poznan | Wielkopolska | 61-701 | Poland |
| ID | Term |
|---|---|
| D005530 | Foot Deformities |
| D005534 | Foot Diseases |
| D002547 | Cerebral Palsy |
| ID | Term |
|---|---|
| D009140 | Musculoskeletal Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001925 | Brain Damage, Chronic |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |
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