Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study
Antonio Coviello,1,* Carmine Iacovazzo,1,* Dario Cirillo,1 Alessio Bernasconi,2 Annachiara Marra,1 Francesco Squillacioti,1 Marco Martone,1 Eleonora Garone,1 Filomena Coppola,1 Andrea Uriel de Siena,1 Maria Vargas,1 Giuseppe Servillo1 1Department of Neurosciences, Reproductive and Od...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2024-04-01
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| Series: | Drug Design, Development and Therapy |
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| Online Access: | https://www.dovepress.com/dexamethasone-versus-dexmedetomidine-as-adjuvants-in-ultrasound-poplit-peer-reviewed-fulltext-article-DDDT |
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| author | Coviello A Iacovazzo C Cirillo D Bernasconi A Marra A Squillacioti F Martone M Garone E Coppola F de Siena AU Vargas M Servillo G |
| author_facet | Coviello A Iacovazzo C Cirillo D Bernasconi A Marra A Squillacioti F Martone M Garone E Coppola F de Siena AU Vargas M Servillo G |
| author_sort | Coviello A |
| collection | DOAJ |
| description | Antonio Coviello,1,* Carmine Iacovazzo,1,* Dario Cirillo,1 Alessio Bernasconi,2 Annachiara Marra,1 Francesco Squillacioti,1 Marco Martone,1 Eleonora Garone,1 Filomena Coppola,1 Andrea Uriel de Siena,1 Maria Vargas,1 Giuseppe Servillo1 1Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy; 2Department of Public Health, School of Medicine, University of Naples “Federico II”, Unit of Orthopedics and Traumatology, Naples, Italy*These authors contributed equally to this workCorrespondence: Antonio Coviello, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Sergio Pansini, 5, Napoli NA, Naples, 80131, Italy, Tel +39 3497013533, Fax +39 0817462281, Email antonio_coviello@live.itBackground and Aim: Ultrasound popliteal sciatic nerve block (UPSNB) is commonly performed in foot and ankle surgery. This study aims to assess the use of dexmedetomidine and dexamethasone as adjuvants in UPSNB for hallux valgus (HV) surgery, comparing their efficacy in producing motor and sensory block and controlling postoperative pain. The adverse event rate was also evaluated.Methods: This mono-centric retrospective study included 62 adult patients undergoing HV surgery: 30 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg and dexamethasone 4 mg (Group 1), whereas 32 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg, and dexmedetomidine 1 mcg/Kg (Group 2). At first, the visual analogue scale (VAS) was evaluated after 48 hours. The other outcomes were time to motor block regression, evaluation of the first analgesic drug intake, analgesic effect, adverse effects (hemodynamic disorders, postoperative nausea and vomiting (PONV)) and patient satisfaction. The continuous data were analyzed with student’s t-test and the continuous one with χ2. Statistical significance was set at a p-value lower than 0.05.Results: No significant difference was found in VAS after 48 hours (4.5 ± 1.6 vs 4.7 ± 1.7, p = 0.621) to motor block regression (18.9 ± 6.0 vs 18.7 ± 6, p = 0.922). The number of patients that took their first analgesic drug in the first 48 h (p = 0.947 at 6 hours; p = 0.421 at 12 hours; p = 0.122 at 24 hours and p = 0.333 at 48 hours) were not significant. A low and similar incidence of intraoperative hemodynamic disorders was recorded in both groups (hypotension p = 0.593; bradycardia p = 0.881). Neither PONV nor other complication was found. Patients in Group 1 reported a lower degree of interference with sleep (p = 0.001), less interference with daily activities (P = 0.002) and with the affective sphere (P = 0.015) along with a more satisfactory postoperative pain management (p < 0.001) as compared to Group 2.Conclusion: No significant differences were observed in the duration of motor and sensory blockade between patients in both groups. Additionally, both groups showed good pain control with a low rate of adverse effects, even if there was no clinical difference between the groups. However, patients who received dexamethasone reported experiencing less interference with their sleep, daily activities and overall emotional well-being, and overall pain control.Keywords: ultrasound popliteal sciatic nerve block, dexamethasone, dexmedetomidine, Hallux valgus, adjuvants in peripheral nerve blocks |
| first_indexed | 2024-04-24T07:47:42Z |
| format | Article |
| id | doaj.art-436daf4de846406a869ac17127ef49f0 |
| institution | Directory Open Access Journal |
| issn | 1177-8881 |
| language | English |
| last_indexed | 2024-04-24T07:47:42Z |
| publishDate | 2024-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Drug Design, Development and Therapy |
| spelling | doaj.art-436daf4de846406a869ac17127ef49f02024-04-18T18:02:45ZengDove Medical PressDrug Design, Development and Therapy1177-88812024-04-01Volume 181231124592027Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative StudyCoviello AIacovazzo CCirillo DBernasconi AMarra ASquillacioti FMartone MGarone ECoppola Fde Siena AUVargas MServillo GAntonio Coviello,1,* Carmine Iacovazzo,1,* Dario Cirillo,1 Alessio Bernasconi,2 Annachiara Marra,1 Francesco Squillacioti,1 Marco Martone,1 Eleonora Garone,1 Filomena Coppola,1 Andrea Uriel de Siena,1 Maria Vargas,1 Giuseppe Servillo1 1Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, 80131, Italy; 2Department of Public Health, School of Medicine, University of Naples “Federico II”, Unit of Orthopedics and Traumatology, Naples, Italy*These authors contributed equally to this workCorrespondence: Antonio Coviello, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Via Sergio Pansini, 5, Napoli NA, Naples, 80131, Italy, Tel +39 3497013533, Fax +39 0817462281, Email antonio_coviello@live.itBackground and Aim: Ultrasound popliteal sciatic nerve block (UPSNB) is commonly performed in foot and ankle surgery. This study aims to assess the use of dexmedetomidine and dexamethasone as adjuvants in UPSNB for hallux valgus (HV) surgery, comparing their efficacy in producing motor and sensory block and controlling postoperative pain. The adverse event rate was also evaluated.Methods: This mono-centric retrospective study included 62 adult patients undergoing HV surgery: 30 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg and dexamethasone 4 mg (Group 1), whereas 32 patients received lidocaine 2% 200 mg, ropivacaine 0.5% 50 mg, and dexmedetomidine 1 mcg/Kg (Group 2). At first, the visual analogue scale (VAS) was evaluated after 48 hours. The other outcomes were time to motor block regression, evaluation of the first analgesic drug intake, analgesic effect, adverse effects (hemodynamic disorders, postoperative nausea and vomiting (PONV)) and patient satisfaction. The continuous data were analyzed with student’s t-test and the continuous one with χ2. Statistical significance was set at a p-value lower than 0.05.Results: No significant difference was found in VAS after 48 hours (4.5 ± 1.6 vs 4.7 ± 1.7, p = 0.621) to motor block regression (18.9 ± 6.0 vs 18.7 ± 6, p = 0.922). The number of patients that took their first analgesic drug in the first 48 h (p = 0.947 at 6 hours; p = 0.421 at 12 hours; p = 0.122 at 24 hours and p = 0.333 at 48 hours) were not significant. A low and similar incidence of intraoperative hemodynamic disorders was recorded in both groups (hypotension p = 0.593; bradycardia p = 0.881). Neither PONV nor other complication was found. Patients in Group 1 reported a lower degree of interference with sleep (p = 0.001), less interference with daily activities (P = 0.002) and with the affective sphere (P = 0.015) along with a more satisfactory postoperative pain management (p < 0.001) as compared to Group 2.Conclusion: No significant differences were observed in the duration of motor and sensory blockade between patients in both groups. Additionally, both groups showed good pain control with a low rate of adverse effects, even if there was no clinical difference between the groups. However, patients who received dexamethasone reported experiencing less interference with their sleep, daily activities and overall emotional well-being, and overall pain control.Keywords: ultrasound popliteal sciatic nerve block, dexamethasone, dexmedetomidine, Hallux valgus, adjuvants in peripheral nerve blockshttps://www.dovepress.com/dexamethasone-versus-dexmedetomidine-as-adjuvants-in-ultrasound-poplit-peer-reviewed-fulltext-article-DDDTultrasound popliteal sciatic nerve blockdexamethasonedexmedetomidinehallux valgusadjuvants in peripherical nerve blocks. |
| spellingShingle | Coviello A Iacovazzo C Cirillo D Bernasconi A Marra A Squillacioti F Martone M Garone E Coppola F de Siena AU Vargas M Servillo G Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study Drug Design, Development and Therapy ultrasound popliteal sciatic nerve block dexamethasone dexmedetomidine hallux valgus adjuvants in peripherical nerve blocks. |
| title | Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study |
| title_full | Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study |
| title_fullStr | Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study |
| title_full_unstemmed | Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study |
| title_short | Dexamethasone versus Dexmedetomidine as Adjuvants in Ultrasound Popliteal Sciatic Nerve Block for Hallux Valgus Surgery: A Mono-Centric Retrospective Comparative Study |
| title_sort | dexamethasone versus dexmedetomidine as adjuvants in ultrasound popliteal sciatic nerve block for hallux valgus surgery a mono centric retrospective comparative study |
| topic | ultrasound popliteal sciatic nerve block dexamethasone dexmedetomidine hallux valgus adjuvants in peripherical nerve blocks. |
| url | https://www.dovepress.com/dexamethasone-versus-dexmedetomidine-as-adjuvants-in-ultrasound-poplit-peer-reviewed-fulltext-article-DDDT |
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