Dexamethasone into nerve block versus IV for pain and inflammation after knee replacement
Route of Dexamethasone Administration in iPACK and ACB for Total Knee Replacement: A Randomized Trial
This trial will test whether giving dexamethasone into the nerve block instead of through an IV reduces pain and inflammation after total knee replacement in adults over 65.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Enrollment | 90 (estimated) |
| Ages | 65 Years to 100 Years |
| Sex | All |
| Sponsor | Poznan University of Medical Sciences Academic / other |
| Locations | 1 site (Poznan) |
| Trial ID | NCT07180953 on ClinicalTrials.gov |
What this trial studies
All participants receive two nerve blocks (iPACK and adductor canal block) before surgery and are randomly assigned to receive dexamethasone either added to the nerve block or given intravenously. Pain levels and postoperative inflammatory response will be measured and compared between the two groups. The trial enrolls patients older than 65 and excludes those with contraindications to regional anesthesia, ongoing steroid therapy, or serious systemic illness. The goal is to determine whether the route of dexamethasone delivery changes analgesia duration or the degree of postoperative inflammation.
Who should consider this trial
Good fit: Adults older than 65 and younger than 100 scheduled for total knee arthroplasty who can give informed consent and reliably report symptoms are the intended participants.
Not a fit: Patients with cognitive or language barriers to consent, infection at the block site, coagulation disorders, immunodeficiency, ASA physical status IV or higher, or regular steroid use are excluded and may not receive benefit from this approach.
Why it matters
Potential benefit: If successful, the approach could provide longer-lasting pain relief and lower inflammation after knee replacement, potentially reducing opioid use and speeding recovery.
How similar studies have performed: Previous trials have shown that adding dexamethasone to peripheral nerve blocks can prolong analgesia, but it remains unclear whether perineural dosing is consistently superior to intravenous administration.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * patients scheduled for total knee arthroplasty * patients aged \>65 and \<100 years * patients can provide informed consent * patients can reliably report symptoms to the research team Exclusion Criteria: * inability to provide first-party consent due to cognitive impairment or a * language barrier * infection at the site of the regional block, * coagulation disorders, * immunodeficiency, * American Society of Anesthesiologists (ASA) physical status of IV or higher, * history of regular steroid medication.
Where this trial is running
Poznan
- Poznan University of Medical Sciences — Poznan, Poland (Recruiting)
Study contacts
- Study coordinator: Malgorzata Reysner, MD PhD
- Email: mreysner@ump.edu.pl
- Phone: +48618738303
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.