Perineural vs Intravenous Dexamethasone as an Adjuvant to Brachial Plexus Block in Pediatr
This clinical trial will evaluate the neurological safety and analgesic effectiveness of dexamethasone administered perineurally or intravenously as an adjuvant to brachial plexus block in children undergoing hand or forearm surgery. Dexamethasone is commonly used to prolong the duration of regional anesthesia, but the
| Condition(s) | Hand Injuries and Disorders, Wrist Sprain |
|---|---|
| Status | Recruiting |
| Phase | NA |
| Study type | Interventional |
| Summary | This clinical trial will evaluate the neurological safety and analgesic effectiveness of dexamethasone administered perineurally or intravenously as an adjuvant to brachial plexus block in children undergoing hand or forearm surgery. Dexamethasone is commonly used to prolong the duration of regional anesthesia, but there is limited evidence on long-term neurological safety, particularly in pediatric patients. All participants will receive a single-shot brachial plexus block using ropivacaine under ultrasound guidance. Patients will be randomized into one of three treatment groups: perineural dexamethasone, intravenous dexamethasone, or placebo. The primary objective is to determine whether perineural dexamethasone causes any clinically significant nerve injury compared with intravenous adm |
| Who can participate | Inclusion Criteria: * Age 3 months to 16 years * Scheduled elective hand or forearm surgery under general anesthesia with a brachial plexus block * ASA physical status I-III * Planned use of ultrasound-guided regional anesthesia * Written informed consent from parent(s) or legal guardian and age-appropriate assent from the child Exclusion Criteria: * Pre-existing neurological disease or peripheral neuropathy * Preoperative sensory deficit in the operative limb * Infection at or near the needle insertion site * Coagulopathy or therapeutic anticoagulation * Systemic infection or sepsis * Chronic steroid therapy within 30 days before surgery * Known allergy to ropivacaine or dexamethasone * Diabetes mellitus * BMI \> 99th percentile for age and sex. * Pregnancy or breastfeeding * Participatio |
| Ages | 3 Months to 16 Years |
| Sex | All |
| Lead sponsor | Poznan University of Medical Sciences |
| Locations | Poznan, Poland |
| Start date | 2025-12-10 |
| NCT ID | NCT07474909 |
| Official listing | https://clinicaltrials.gov/study/NCT07474909 |