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Background and Aims This study aimed to assess the effect of two doses of perineural dexamethasone (DXM) on sensory and motor block duration, opioid requirement, blood glucose levels, and stress response to surgery expressed by the neutrophile-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), following foot and ankle surgery.

Methods In this RCT, 90 patients aged 2-5 years old, ASA 2-3 were randomized into 3 equal groups, each receiving an ultrasound-guided single-shot popliteal sciatic nerve block with 0.5ml/kg 0.2% ropivacaine, supplemented with saline, DXM 0.1mg/kg, or DXM 0.05mg/kg.

Results The sensory block was significantly longer for DEX 0.1mg/kg 18.42 (2.62) h and DEX 0.05mg/kg 16.27 (2.82) h, compared to saline 8.52 (1.45) h, p<0.0001. The motor block was significantly longer for DEX 0.1mg/kg 17.25 (2.47) and DEX 0.05mg/kg 15.23 (2.65), compared to saline 7.78 (1.14), p=0.0006. Total opioid consumption was lower in both DEX groups (p=0.0006), as seen in table 2. The NLR, PLR and glucose levels before, 24h and 48h after surgery, did not differ in all groups, as seen in table 4.

Conclusions The addition of DXM to ropivacaine significantly prolonged the duration of postoperative sensory and motor block. DXM did not influence the NLR, PLR and blood glucose levels.