A randomised controlled trial of perineural vs intravenous dexamethasone for foot surgery

90 patients who were scheduled to undergo metatarsal osteotomy underwent an ankle blockade (20ml ropivacaine 0.75%) prior to surgery and then were randomized to either a perineural dexamethasone (8mg) injection and intravenous saline 0.9%, perineural saline 0.9% injection and intravenous dexamethasone (8mg), or perinerural and intravenous saline 0.9%. The purpose of this study was to determine whether dexamethasone was beneficial for prolonging the analgesic effects of the ankle blockade and to determine whether the perineural or intervenous route of dexamethasone administration was more effective. The findings of this trial indicated that the use of dexamethasone prolonged the analgesic effect of the ankle blockade compared to saline. Postoperative pain scores, analgesic use, and nausea and vomitting were similar between the three groups. Aditionally, there were no differences between perineural and intravenous routes of dexamethasone administration.