This research investigated whether intravenous dexamethasone added to an interscalene block (a standard method of pain control for shoulder surgery) would be better than the block alone for controlling pain after rotator cuff repair surgery. Rotator cuff surgery is likely to produce intense postoperative pain, and good methods of alleviating this pain are needed. Interscalene blocks are good for the relief of pain for a limited time, but they have rebound pain, and their action is not prolonged and needs to be supplemented.
The authors examined 73 patients who were treated with arthroscopic rotator cuff repair from 2018 to 2023. The patients were separated into two groups: the first group received the interscalene block alone (Group C: 32 patients), and the second group received 3.3 mg intravenous dexamethasone before the block (Group D: 41 patients). The primary aim was to investigate whether the addition of dexamethasone decreased the amount of rescue drugs (additional analgesics) and the time to the point when the patients initially required those drugs.
The outcome was stunning. Group D required much less rescue pain medication (63% of patients) versus Group C (97%). They required rescue medication later as well—approximately 21.7 hours post-op in Group D versus 9.3 hours in Group C. Group D required pain medications less often within the first 72 hours post-op. Notably, there were no complications in either group. In plain terms, the addition of intravenous dexamethasone to the nerve block significantly enhanced analgesia, enabling patients to use less pharmacologic intervention and enjoy extended durations of post–operative comfort.
The synergistic effect is based on dexamethasone‘s action to extend the effect of the nerve block by inhibiting inflammation and slowing the absorption rate of the anesthetic. Authors propose that this method may prove to be an even superior option for post-rotator cuff surgery pain management.
