Analgésie et réanimation : recherche actuelle

Oral Prednisone Increased Quality of Analgesia after Single-Shot Supraclavicular Nerve Block

Katarina Tomulic Brusich, Ivana Acan and Natasa Viskovic Filipcic

Objective:

Peripheral nerve blocks (PNB) have become a highly favorable anesthetic option for limb surgery. To enhance patient comfort and postoperative analgesia dexamethasone has been implemented as adjunct to local anesthetics, either perineuraly or intravenously, with similar effect. We hypothesized that also oral corticosteroids can prolong analgesia after single-shot supraclavicular nerve block (SCB) regardless of the route of administration.

Methods:

A single-center retrospective study was conducted among two specific groups of patients who had undergone SCB for upper limb surgery: patients after kidney transplantation (Tx) with chronic prednisone consumption and non-transplanted (Non- Tx) patients. The primary outcome was duration of analgesia after single-shot SCB. Secondary outcomes included patients’ comfort score during block performance, postoperative patients’ pain scores and the incidence of block related complications.

Results:

The groups were comparable in demographics (age, gender) and ASA status. Main statistical difference is observed among BMI (Tx 32.40 +/- 6.18 vs. Non-Tx 26.90 +/- 3.61, P=0.0064). Volume of administrated LA, block onset and duration were comparable between groups. The main difference was observed in VAS score upon first analgesic request (Tx 3 (IQR 1-6) vs. Non-Tx 6 (IQR 3-8), P=0.0348), suggesting that pain was more severe in Non-Tx group.

Conclusion:

Peroral prednisone in dose of 20 mg does not prolong single-shot SCB duration but significantly improves postoperative pain score. We advocate the use of peroral form of corticosteroids because it could increase patient’s satisfaction and could reduce treatment costs.