Background and Goal of Study:
Sciatic-Popliteal Blockade (SPB) provides a good anesthetic level during Hallux surgery. The addition of adjuvant drugs to local anesthetics (LA) improves the quality of nerve plexus blockade, including dexamethasone (DXM) because of its antiinflammatory and decreasing vascular permeability effect.
The aim of our study is to assess the effect of DXM on the duration of postoperative analgesia in Hallux surgery, comparing the local administration versus intravenous.

Materials and methods:
Prospective, randomized study in patients scheduled for Hallux Valgus Surgery under sedation Midazolam 2mg and SPB as follows:
Group 1 (n = 19): SPB with Ropivacaine 0.475%
Group 2 (n = 23): DXM (8 mg) in the SPB with Ropivacaine 0.475%
Group 3 (n = 22): SPB and DXM (8 mg) intravenously.
Age, ASA, weight, duration of surgery and consumption of analgesics and opioids were recorded intraoperative.
Postoperatively, we recorded VAS (Visual Analogic Scale), duration of sensory and motor blockade, rescue analgesia, side effects and readmissions.
Statistical analysis: ANOVA (Analysis of Variance) with SPSS v18.0.

Results and discussion:
No statistically significant differences were found for demographic and intraoperative variables. There was a longer duration of the sensory blockade in groups 2 and 3 (22.75h ± 4.3 and 23.64h ± 4.7) compared to Group 1 (17.53 ± 3.8), although it was not statistically significant. There were also no statistically significant differences regarding VAS and duration of motor block between the 3 groups. We found significantly differences in number of readmissions. Only one of the patients in Group 1 required general anesthesia and no side effects were reported due to the drug.
Instead of our results showed a non significantly extension of the sensory block with the
administration of DXM intravenously, the decreasing in readmissions is a great clinical sign that shows a better pain control.

Conclusion:
It is necessary to conduct studies with a larger sample size to evaluate the clinical impact of the different routes of administration of DXM in patients with locoregional Anesthesia-Analgesia.

Effect of the addition of dexamethasone on the effectiveness and duration of the sciatic-popliteal block with ropivacaine for Hallux surgery