{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T16:22:16Z","timestamp":1777998136931,"version":"3.51.4"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reconstruction of the anterior cruciate ligament (ACL) often causes severe postoperative pain. This study aimed to assess how dexamethasone affects the analgesic effectiveness of the adductor canal block (ACB), opioid use, and rebound pain after ACL reconstruction with a bone-patellar tendon-bone (BPTB) graft.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This non-randomized prospective study analyzed a total of 160 patients, who were divided into two groups: the Dexamethasone\u202f+\u202fACB group and the ACB group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Within the first 24\u202fh after surgery, there was no difference between the groups in the percentage of patients experiencing pain (73.75% vs. 85%;\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f2.4433;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.118) or in pain severity during activity (1.74\u202f\u00b1\u202f0.97 vs. 1.59\u202f\u00b1\u202f0.65;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.779). During the first 48\u202fh after surgery, no significant difference was observed in opioid use between the groups. Three patients in the non-dexamethasone group reported rebound pain (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f0.2564;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.61), while blood glucose levels were significantly higher in the dexamethasone group (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f4.329;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The addition of dexamethasone to the local anesthetic during ACB after ACL reconstruction is not supported due to the lack of benefits related to postoperative pain levels and the associated increase in glucose levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1696393","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T05:16:01Z","timestamp":1768281361000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Is there a benefit to adding dexamethasone to levobupivacaine in ultrasound-guided adductor canal block following anterior cruciate ligament reconstruction?"],"prefix":"10.3389","volume":"12","author":[{"given":"Svetlana","family":"Sreckovic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petar","family":"Vukman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radmila","family":"Klacar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Odalovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vesna","family":"Jovanovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miljan","family":"Bilanovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darko","family":"Milovanovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"105636","DOI":"10.1016\/j.clinbiomech.2022.105636","article-title":"Biomechanical properties of common graft choices for anterior cruciate ligament reconstruction: a systematic review","volume":"95","author":"Malige","year":"2022","journal-title":"Clin Biomech Bristol Avon"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1097\/JSA.0000000000000265","article-title":"Graft selection in anterior cruciate ligament reconstruction","volume":"28","author":"Lin","year":"2020","journal-title":"Sports Med Arthrosc Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3531","DOI":"10.1177\/0363546518825340","article-title":"Anterior cruciate ligament reconstruction: a systematic review and meta-analysis of outcomes for quadriceps tendon autograft versus bone\u2013patellar tendon\u2013bone and hamstring-tendon autografts","volume":"47","author":"Mouarbes","year":"2019","journal-title":"Am J Sports Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2368","DOI":"10.1016\/j.arthro.2022.06.001","article-title":"All-inside anterior cruciate ligament reconstruction","volume":"38","author":"Nuelle","year":"2022","journal-title":"Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1016\/j.anclin.2022.04.002","article-title":"Multimodal Analgesia","volume":"40","author":"O\u2019Neill","year":"2022","journal-title":"Anesthesiol Clin"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"737","DOI":"10.2217\/pmt-2021-0116","article-title":"Paracetamol for multimodal analgesia","volume":"12","author":"Freo","year":"2022","journal-title":"Pain Manag"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3132","DOI":"10.1177\/0363546520980429","article-title":"Contribution of multimodal analgesia to postoperative pain outcomes immediately after primary anterior cruciate ligament reconstruction: a systematic review and Meta-analysis of level 1 randomized clinical trials","volume":"49","author":"Maheshwer","year":"2021","journal-title":"Am J Sports Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e721","DOI":"10.1016\/j.asmr.2021.09.011","article-title":"Postoperative multimodal pain management and opioid consumption in arthroscopy clinical trials: a systematic review","volume":"4","author":"Paul","year":"2022","journal-title":"Arthrosc Sports Med Rehabil"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1016\/j.arthro.2021.10.031","article-title":"Periarticular local infiltrative anesthesia and regional Adductor Canal block provide equivalent pain relief after anterior cruciate ligament reconstruction","volume":"38","author":"Schaver","year":"2022","journal-title":"Arthrosc J Arthrosc Relat Surg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"23259671241292029","DOI":"10.1177\/23259671241292029","article-title":"Local infiltration analgesia versus Adductor Canal block for managing pain after anterior cruciate ligament reconstruction: a systematic review and Meta-analysis","volume":"12","author":"Nadeem","year":"2024","journal-title":"Orthop J Sports Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.jclinane.2016.08.021","article-title":"Adductor canal block for knee surgical procedures: review article","volume":"35","author":"Vora","year":"2016","journal-title":"J Clin Anesth"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1016\/j.bja.2023.09.022","article-title":"Prophylactic dexamethasone for rebound pain after peripheral nerve block in adult surgical patients: systematic review, meta-analysis, and trial sequential analysis of randomised controlled trials","volume":"132","author":"Singh","year":"2024","journal-title":"Br J Anaesth"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.anclin.2022.03.002","article-title":"Rebound pain after peripheral nerve blockade-bad timing or rude awakening?","volume":"40","author":"Stone","year":"2022","journal-title":"Anesthesiol Clin"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1016\/j.bja.2020.10.035","article-title":"Factors associated with rebound pain after peripheral nerve block for ambulatory surgery","volume":"126","author":"Barry","year":"2021","journal-title":"Br J Anaesth"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1213\/ANE.0000000000002488","article-title":"Optimal dose of perineural dexamethasone to prolong analgesia after brachial plexus blockade: a systematic review and meta-analysis","volume":"126","author":"Kirkham","year":"2018","journal-title":"Anesth Analg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1016\/j.bja.2023.12.021","article-title":"Dose\u2013response relationships of intravenous and perineural dexamethasone as adjuvants to peripheral nerve blocks: a systematic review and model-based network meta-analysis","volume":"132","author":"Zufferey","year":"2024","journal-title":"Br J Anaesth"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1186\/s12871-021-01440-4","article-title":"Effects of the addition of dexamethasone on postoperative analgesia after anterior cruciate ligament reconstruction surgery under quadruple nerve blocks","volume":"21","author":"Aoyama","year":"2021","journal-title":"BMC Anesthesiol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.2337\/dc25-S002","article-title":"Diagnosis and classification of diabetes: standards of care in diabetes-2025","volume":"48","year":"2025","journal-title":"Diabetes Care"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e29295","DOI":"10.1097\/MD.0000000000029295","article-title":"Comparison of adductor canal block and femoral nerve block for pain management in anterior cruciate ligament reconstruction: a meta-analysis of randomized controlled trials","volume":"101","author":"Yin","year":"2022","journal-title":"Medicine (Baltimore)"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"6019","DOI":"10.3390\/jcm12186019","article-title":"The effectiveness of Adductor Canal block compared to femoral nerve block on readiness for discharge in patients undergoing outpatient anterior cruciate ligament reconstruction: a multi-center randomized clinical trial","volume":"12","author":"Ten Hoope","year":"2023","journal-title":"J Clin Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"CD011770","DOI":"10.1002\/14651858.CD011770.pub2","article-title":"Dexamethasone as an adjuvant to peripheral nerve block","volume":"11","author":"Pehora","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1002\/ejp.1292","article-title":"Ultrasound-guided adductor canal block after arthroscopic anterior cruciate ligament reconstruction: effect of adding dexamethasone to bupivacaine, a randomized controlled trial","volume":"23","author":"Ibrahim","year":"2019","journal-title":"Eur J Pain"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"76","DOI":"10.5704\/MOJ.2203.011","article-title":"Low-dose perioperative dexamethasone improves 24-hour post-operative pain after anterior cruciate ligament reconstruction","volume":"16","author":"Khatri","year":"2022","journal-title":"Malays Orthop J"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1213\/ANE.0000000000006933","article-title":"Impact of intraoperative dexamethasone on perioperative blood glucose levels: systematic review and Meta-analysis of randomized trials","volume":"139","author":"Katerenchuk","year":"2024","journal-title":"Anesth Analg"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1002\/pmrj.12042","article-title":"Systemic absorption and side effects of locally injected glucocorticoids","volume":"11","author":"Stout","year":"2019","journal-title":"PM R"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s42077-023-00334-6","article-title":"Perioperative hyperglycemic response to single-dose dexamethasone in patients undergoing surgery under spinal anesthesia","volume":"15","author":"Joshi","year":"2023","journal-title":"Ain-Shams J Anesthesiol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"3794","DOI":"10.1177\/03635465211045394","article-title":"Can we eliminate opioids after anterior cruciate ligament reconstruction? A prospective, randomized controlled trial","volume":"49","author":"Moutzouros","year":"2021","journal-title":"Am J Sports Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1696393\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T05:16:01Z","timestamp":1768281361000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1696393\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,13]]},"references-count":27,"alternative-id":["10.3389\/fmed.2025.1696393"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1696393","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,13]]},"article-number":"1696393"}}