title: Perineural dexamethasone does not enhance the analgesic efficacy of ultrasound-guided subcostal transversus abdominis plane block during laparoscopic cholecystectomy.
abstract: BACKGROUND
  Ultrasound-guided transversus abdominis plane (TAP) block is an adjunct therapy to provide effective postoperative analgesia in abdominal surgical procedures. Dexamethasone is a supplement agent that can improve the efficacy of local anesthesia. However, information about its additive effect is limited. This study aimed to compare the analgesic efficiency using ultrasound-guided TAP block with and without perineural dexamethasone for patients who underwent laparoscopic cholecystectomy.
  
  
  METHODS
  Sixty patients who underwent laparoscopic cholecystectomy were randomly divided into three groups: group I, controls; group II, TAP; and group III, TAP+perineural dexamethasone supplement. The requirement of additional analgesia and the first-time request of rescue-analgesia were recorded after operation and the numerical rating scale was evaluated at specific intervals.
  
  
  RESULTS
  Compared to group I, the first-time requirement of rescue-analgesia in groups II and III was significantly delayed (403.0+/-230.9, 436.0+/-225.3 vs 152.3+/-124.7, P<0.01). Compared with those in group I, patients in groups II and III were associated with lower numerical rating scale pain scores (P<0.01) and less postoperative analgesic consumption (P<0.01). There was no significant difference in the variables mentioned above between groups II and III (P>0.05).
  
  
  CONCLUSIONS
  Perineural dexamethasone has no additive/synergistic effect with subcostal TAP block on analgesic efficacy for the patients undergoing laparoscopic cholecystectomy.
authors.affiliation: Department of Anesthesiology and Department of Orthopedics, Second Hospital of Lanzhou University, Lanzhou 730030, China. wsk2zzy@126.com.
authors.forename: Sheng-Hui
authors.initials: SH
authors.lastname: Huang
authors.forename: Jing
authors.initials: J
authors.lastname: Lu
authors.forename: Hong-Yun
authors.initials: HY
authors.lastname: Gan
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.forename: Yong-Gang
authors.initials: YG
authors.lastname: Peng
authors.forename: Shuan-Ke
authors.initials: SK
authors.lastname: Wang
mesh_terms: D000009:Abdominal Muscles / Q000294:innervation*; D000328:Adult; D000577:Amides / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002681:China; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D017288:Pain Threshold / Q000187:drug effects; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D000077212:Ropivacaine; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D005938:Glucocorticoids; D000077212:Ropivacaine; D003907:Dexamethasone