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The effect of perineural dexamethasone on nerve injury and recovery of nerve function after surgery: A randomized
Na Zhu1, Bingbing Xiang2, Jinghong Shi1
1Department of Anesthesiology, Clinical Medical College and the First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
Background:
While numerous studies have examined the influence of perineural dexamethasone on nerve block duration, its potential impact on postoperative nerve injury has not been adequately addressed.
Objective:
This study aims to elucidate the effect of perineural dexamethasone on nerve injury and nerve function recovery after surgery.
Design:
A prospective randomized double-blinded trial.
Setting:
The First Affiliated Hospital of Chengdu Medical College, Chengdu, China. The study was conducted between 14 June and 30 December 2022.
Participants:
Patients aged 18 - 80 years, ASA I - II, scheduled for elective orthopedic or burn and plastic surgery.
Interventions:
Patients were randomized to receive either perineural dexamethasone (D group) or no dexamethasone (ND group).
Main Outcome Measures:
Primary outcomes were the incidence and recovery of nerve injury. Secondary outcomes included postoperative pain scores, analgesic consumption, and adverse events.
Results:
Initial postoperative nerve injury rates were similar between groups (D: 30.4 %, ND: 33.3 %, P > 0.05). At 12 weeks post-discharge, significantly more patients in the ND group recovered from nerve deficits (78.8 % vs 60.3 %; OR = 2.45, 95 % CI = 1.05 - 5.72, P < 0.05). No significant differences were observed in postoperative hyperglycemia or surgical site infection rates.
Conclusion:
Perineural dexamethasone may impede nerve function recovery, suggesting caution in its use, particularly for patients with pre-existing nerve damage or diabetes. Further research is needed to elucidate the long-term effects of dexamethasone on nerve tissue recovery.
Trial Registration:
chictr.org.cn, ChiCTR2200059424.
