Perineural Dexamethasone in Femural Nerve Block After Ligament Reconstruction

After Ethics committee approval, 75 patients American Society of Anesthesiologists score (ASA) I-III were randomized at the end of surgery into 3 groups of 25 patients each who underwent femoral nerve block: group A with 20 ml ropivacaine 0,5% and 20 ml lidocaine 1%; group B with 20 ml ropivacaine 0,5%, 20 ml lidocaine 1% and 4 mg dexamethasone; group C with 20 ml ropivacaine 0,5%, 20 ml lidocaine 1% and 8 mg dexamethasone.

All groups received postoperative analgesia when visual analog scale (VAS) over 3 (by request), with IV Perfalgan 1 g and morphine (loading dose 0.1 mg/kg and titration until VAS under 3, followed by subcutaneous (SC) administration of 1/2 of total loading dose on demand for the following 24 hours (h) .

Efficacy was evaluated by the time interval from performing the block until the first analgesic dose required, the total amount of morphine in the first 24 h postoperative, the patient satisfaction and the neurological side effects.

Inclusion criteria

• ASA I-III
• BMI<40

Exclusion criteria

• High risk grade hypertension
• Chronic renal failure
• Known allergy to drugs used
• Chronic treatment with steroids
• Drugs dependency
• History of diabetes mellitus
• Ulcer or chronic gastritis
• Infection on the puncture site
• Neuropathy at the surgical level
• Coagulopathy
• Requesting another type of anesthesia
• Fear to sign informed consent
• By-pass aorto-femoral