Comparison between low-volume local anesthetic with intravenous dexamethasone and conventional volume without dexamethasone for superior trunk block after arthroscopic shoulder surgery: a randomized controlled non-inferiority trial
Authors' conclusion
Superior trunk block using low-volume local anesthetic with intravenous dexamethasone can reduce the incidence of diaphragmatic paresis while providing non-inferior analgesic duration compared with the conventional volume of local anesthetic in patients undergoing arthroscopic shoulder surgery.
Study context
- Population
- Adults undergoing arthroscopic shoulder surgery under GA
- Participants
- 84 adults
- Comparison
- Treatment vs Control
- Primary endpoint
- Co-primary: (1) duration of analgesia (block completion to surgical pain NRS ≥4; non-inferiority margin 3 hours); (2) incidence of diaphragmatic paresis (M-mode ultrasonography in PACU)
Methodological detailsnon-inferiority
- Non-inferiority
Primary result
As reported in the abstract
Duration of analgesia; diaphragmatic paresis
Treatment
12.4
mean · SD 6.8 · hours
Control
11.2
mean · SD 4.6 · hours
Treatment
45.2%
Control
85.4%
Treatment vs ControlMean difference, hours (95% CI)P value
Duration of analgesia; non-inferiority criteria met (margin 3 hours)
−1.2(−3.8 to 1.3)
P < 0.001for non-inferiorityTreatment vs ControlRelative risk (97.5% CI)P value
Diaphragmatic paresis
0.53(0.35–0.80)
P < 0.001Non-inferiority margin 3 as printed, not drawn
Original publication
Comparison between low-volume local anesthetic with intravenous dexamethasone and conventional volume without dexamethasone for superior trunk block after arthroscopic shoulder surgery: a randomized controlled non-inferiority trial. Reg Anesth Pain Med. Published 29 September 2023. doi:10.
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