REDUCE Trial: Perineural Dexamethasone on Scalp Nerve Blocks
Status:
Recruiting
Trial end date:
2022-07-01
Target enrollment:
Participant gender:
Summary
Pain is common in the first 2 days after major craniotomy. Inadequate analgesia may lead to
an increased risk of postoperative complications. Most pain following craniotomy arises from
the pericranial muscles and soft tissues of the scalp. Scalp nerve blocks with local
anesthesia seem to provide effective, safe, however transient postoperative analgesia which
does not seem to meet the requirements of craniotomy. Currently, peripheral dexamethasone has
been observed to significantly prolong the duration of analgesia of nerve blocks (e.g.,
saphenous nerve block, adductor canal block, thoracic paravertebral block, brachial plexus
nerve block). On the contrary, a study reported that perineural dexamethasone did not appear
to prolong the analgesic time after supratentorial craniotomy. However, all patients in this
study were given 24 mg of oral or intravenous dexamethasone regularly at least 7 days during
the perioperative period, which possibly masked the role of single local low doses of
perineural dexamethasone. Therefore, the analgesic effect of single dexamethasone for scalp
nerve blocks without the backdrop of perioperative glucocorticoid deserves further
clarification.