![]() ![]() Additionally, other case reports have demonstrated a prolonged analgesic effect when using the Dex-Dex combination in interscalene and transversus abdominis plane blocks. found that patients who received the Dex-Dex combination had approximately 3.5 more hours of postoperative pain relief and required significantly less fentanyl after surgery when compared to dexmedetomidine and dexamethasone groups. Another study observed the effect of the Dex-Dex block in intercostal nerve blocks for thoracoscopic pneumonectomy. Time to first use of analgesia was four hours longer than the dexmedetomidine group and six hours longer than the dexamethasone group, respectively. ![]() Patients who received the Dex-Dex combination had significantly decreased pain scores up to six hours after surgery compared to those who received only dexamethasone or only dexmedetomidine. Primary outcomes of the study were pain scores and time to analgesia request. compared the effects of the Dex-Dex combination to using each agent by itself in combination with bupivacaine in caudal blocks for pediatric hypospadias repair. The needle was then relocated laterally and deeper, coming to rest between the pectoralis minor and serratus anterior muscles, and an additional 15 mL of the anesthetic was administered. Hydrodissection was performed between the pectoralis major and the pectoralis minor, and 15 mL of the anesthetic was administered into the area. The anesthetic consisted of 30 mL of 0.2% ropivacaine, dexmedetomidine 25 mcg, and dexamethasone 4 mg. An echogenic block needle was advanced in-plane coming to rest in between the pectoralis major and pectoralis minor. The thoracoacromial artery, pectoralis major, pectoralis minor, serratus anterior, and intercostal muscles were identified (Figure 1). A low-frequency ultrasound transducer was placed over the lateral aspect of the anterior chest wall and sterile coupling gel was applied. The patient was supine on an operating table, with her left arm placed at her side. After induction of anesthesia, we performed Pecs I and II blocks for postoperative pain control. Patient consent to publish this case was obtained. She was requiring oxycodone-acetaminophen as needed for pain. ![]() Our patient was a 68-year-old African American female with a past history remarkable for dyslipidemia, mitral valve prolapse, partial hysterectomy, and appendectomy. We performed a preoperative ultrasound-guided Pecs I and II blocks for surgical excision and biopsy of a cystic mass of the left breast located on the medial aspect of the breast 2 cm from the sternal border. ![]()
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