{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:43:05Z","timestamp":1792806185921,"version":"4.5.0"},"reference-count":28,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2024,8,14]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"\n Background<\/jats:title>\n This study assessed the effect of perineural dexamethasone on block duration, opioid requirement, blood glucose levels, and stress response to surgery as measured by the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), following pediatric foot and ankle surgery.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this parallel, double-blinded randomized controlled trial, 90 children (ages 2\u20135 years, >5\u2009kg) scheduled for foot or ankle surgery under spinal anesthesia with ultrasound-guided single-shot popliteal sciatic nerve block were randomized into 3 groups: 0.5% ropivacaine with saline (control), 0.5% ropivacaine plus dexamethasone 0.1\u2009mg\/kg (DEX0.1), and 0.5% ropivacaine plus dexamethasone 0.05\u2009mg\/kg (DEX0.05). Primary outcome was the time to first rescue opioid analgesia. Secondary outcomes included motor block duration, pain scores, NLR, PLR, and blood glucose levels.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Time to first rescue opioid analgesia was significantly longer in the DEX0.1 group compared with the DEX0.05 group (18.4\u2009hours, SD 2.6\u2009hours vs 16\u2009hours, SD 2.8\u2009hours), with a mean difference of 2.2\u2009hours (95%\u2009CI 0.7 to 3.6), p<0.01; and the control group (8.5\u2009hours, SD 1.5\u2009hours), with a mean difference of \u22129.9 (95% CI \u221211.4 to \u22128.4), p<0.001. Motor block was significantly longer in the DEX0.1 group (17.3\u2009hours, SD 2.5\u2009hours) compared with the DEX0.05 (15.2 hours, SD 2.7\u2009hours; p<0.01) and control groups (7.8\u00b11.1, p<0.001). Total opioid consumption was significantly lower in the DEX0.1 group compared with the control group (p=0.01). NLR, PLR, and glucose levels did not differ significantly between the groups at baseline, 24\u2009hours, and 48\u2009hours post surgery.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Perineural dexamethasone significantly prolonged postoperative motor block duration and did not influence blood glucose, NLR, or PLR levels.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT06086418<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/rapm-2024-105694","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T22:30:44Z","timestamp":1724970644000},"page":"970-976","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Dexamethasone as a perineural adjuvant to a ropivacaine popliteal sciatic nerve block for pediatric foot surgery: a randomized, double-blind, placebo-controlled trial"],"prefix":"10.1136","volume":"50","clinical-trial-number":[{"clinical-trial-number":"nct06086418","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06086418","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9067-0969","authenticated-orcid":false,"given":"Malgorzata","family":"Reysner","sequence":"first","affiliation":[{"name":"Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Reysner","sequence":"additional","affiliation":[{"name":"Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Janusz","sequence":"additional","affiliation":[{"name":"Spine Disorders and Pediatric Orthopedics, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Kowalski","sequence":"additional","affiliation":[{"name":"Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milud","family":"Shadi","sequence":"additional","affiliation":[{"name":"Spine Disorders and Pediatric Orthopedics, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Przemys\u0142aw","family":"Daroszewski","sequence":"additional","affiliation":[{"name":"Organization and Management in Health Care, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4017-3013","authenticated-orcid":false,"given":"Katarzyna","family":"Wieczorowska-Tobis","sequence":"additional","affiliation":[{"name":"Palliative Medicine, Poznan University of Medical 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