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Effect of Perineural Dexamethasone on the Duration of Supraclavicular Brachial Plexus Block for Anesthesia After Pediatric Hand/Wrist Surgery
This study is proposed to explore the effect of perineurial Dexamethasone on the duration of supraclavicular brachial plexus block for analgesia after pediatric ankle surgery.
After hand and wrist 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 essential in children due to the much lower toxicity threshold of local anesthetics. An effective adjuvant, such as Dexamethasone, could allow for a higher dilution of local anesthetics while maintaining and enhancing their analgesic effect.
There is considerable research where intravenous and perineural dexamethasone use has been compared in adults. However, there is a massive lack of research regarding children.
In this study, investigators compare different doses of perineural Dexamethasone. Groups 2 and 3 have dexamethasone doses of 0.1mg/kg and 0.05mg/kg added to local anesthetic.
The investigator's goal is to find a dexamethasone dose that is as low as possible but simultaneously covers the need for good pain relief and fast recovery postoperatively.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo | Active Comparator | 0.2% ropivacaine for supraclavicular brachial plexus block |
|
| 0.1mg/kg Dexamethasone | Active Comparator | 0,1mg/kg dexamethasone added to 0.2% ropivacaine for supraclavicular brachial plexus block |
|
| 0,05mg/kg dexamethasone | Active Comparator | 0,05mg/kg dexamethasone added to 0.2% ropivacaine for supraclavicular brachial plexus block |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo | Drug | administration of 0.5ml/kg of 0,2% ropivacaine + 0.01ml/kg 0.9% sodium chloride for the supraclavicular brachial plexus 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 |
|---|---|---|
| Leszek Romanowski, Prof.dr hab. | Poznan University of Medical Sciences | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Poznan University of Medical Sciences | Skórzewo | Poznań | 61-701 | Poland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41940446 | Derived | Reysner T, Ciftci B, Bialka S, Gola W, Czarecki P, Pietraszek P, Kowalski G, Daroszewski P, Reysner M. Low-Dose Perineural Dexamethasone Enhances Analgesia After Pediatric Hand Surgery Without Elevating Systemic Stress Markers: A Randomized Controlled Trial. J Pediatr Orthop. 2026 Apr 6. doi: 10.1097/BPO.0000000000003287. Online ahead of print. |
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| 0.1mg/kg Dexamethasone | Drug | administration of 0.5ml/kg of 0.2% ropivacaine with 0.1mg/kg Dexamethasone for the supraclavicular brachial plexus block |
|
|
| 0.05mg/kg Dexamethasone | Drug | administration of 0.5ml/kg of 0,2% ropivacaine with 0.05mg/kg Dexamethasone for the supraclavicular brachial plexus 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 | Finger 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 |
| ID | Term |
|---|---|
| D006230 | Hand Injuries |
| D014954 | Wrist Injuries |
| D004194 | Disease |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
| D001134 | Arm Injuries |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D012965 | Sodium Chloride |
| D003907 | Dexamethasone |
| ID | Term |
|---|---|
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |
| D011246 | Pregnadienetriols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013259 | Steroids, Fluorinated |
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