Adjuvant dexamethasone for bupivacaine sciatic and ankle blocks: results from 2 randomized placebo-controlled trials.

Background And Objectives: Dexamethasone as a local anesthetic adjuvant has been shown to prolong the time to first postoperative pain and improve postoperative analgesia following upper-limb brachial plexus block. However, the lack of systemically administered dexamethasone in controls makes interpretation of previous studies difficult. We performed 2 prospective, randomized, double-blind, placebo-controlled trials to test whether the addition of dexamethasone 8 mg to bupivacaine for sciatic and ankle blocks prolongs block duration, improving postoperative analgesia.

Low-volume ultrasound-guided nerve block provides inferior postoperative analgesia compared to a higher-volume landmark technique.

Background And Objectives: Ultrasound guidance reduces the required local anesthetic volume for successful peripheral nerve blockade, but it is unclear whether this impacts postoperative analgesia. This prospective, randomized, observer-blinded study tested the hypothesis that a low-volume ultrasound-guided ankle block would provide similar analgesia after foot surgery compared with a conventional-volume surface landmark technique.

Methods: A total of 72 patients presenting for elective foot surgery under general anesthesia were randomized to receive a low-volume ultrasound-guided ankle block (n = 37; ropivacaine 0.

The mid-term results of a dual offset uncemented stem for total hip arthroplasty.

The Synergy stem is a third-generation proximal in-growth, tapered titanium alloy uncemented stem, with standard and high offset versions. Two hundred ten primary hip arthroplasties were performed using the Synergy stem in 193 patients. There were 124 males and 69 females with an average age of 58 years (range, 22-85 years).