الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Shoulder surgeries are frequently associated with post-operative pain that is considered anaesthesiologists main concern. Pain following surgery is a major issue that has its own pathophysiology and should be treated promptly.
Post-operative assessment of the pain characteristics and the efficacy of the analgesic interventions used should be done following any surgery. An irrational use of analgesics in order to ease post-operative pain can be deleterious to the patient. Also, the risk of developing chronic post-operative pain is directly associated with the intensity of acute post-operative pain as patients with higher pain scores within the first month after surgery have a higher chance of developing post-operative persistent pain. That’s why, careful assessment is indicated to appropriately evaluate and treat post-operative pain.
Apart from being unethical, inadequate pain relief may result in increased morbidity and mortality. Opioid-sparing, balanced analgesia provides enhanced pain relief and faster recovery compared with opioids or local anaesthetics alone.
A starting point in effective peri-operative analgesia is Preemptive analgesia. It prevents establishment of the altered sensory processing that amplifies post-operative pain. The treatment should cover the entire duration of high-intensity noxious stimulation that can lead to establishment of central and peripheral sensitization caused by incisional or inflammatory injuries.
The current study was carried out in Alexandria Main University Hospital (AMUH) on 60 patients planned for elective arthroscopic shoulder surgery. The study aimed to evaluate the effect of adding intravenous versus perineural dexamethasone in a single shot ultrasound guided interscalene block for arthroscopic shoulder surgeries.
During this study, patients were equally, and randomly divided into three groups: group I; Patients will receive general anaesthesia with US guided ISB, and 8mg perineural dexamethasone; (PN group). group II; Patients will receive general anaesthesia with US guided ISB, and 8mg intravenous (IV) dexamethasone; (IV group). group III; patients will receive general anaesthesia with US guided ISB alone; (C group).
In the current study, there was no significant statistical difference regarding patients’ demographic data; Age, gender, weight, and height. ASA classification of patients in both groups had no significant difference. Also, duration of surgery in the three groups had no significant difference.
Peri-operative vital signs monitoring included changes in heart rate, MABP, SpO2, and respiratory rate. Heart rate and MABP monitoring revealed insignificant difference in the three groups throughout the pr