Efficacy of Intravenous Dexamethasone in Prolonging the Duration of Spinal Anesthesia With Chloroprocaine in Knee Arthroscopy

Chloroprocaine is a short-acting local anesthetic that allows rapid recovery and early ambulation but is currently recommended for procedures lasting 40 minutes or less. Dexamethasone is commonly used during anesthesia for the prevention of postoperative nausea and vomiting and has also been shown to prolong the duration of analgesia and sensory block after regional anesthesia. Dexamethasone may therefore extend the duration of chloroprocaine spinal anesthesia, potentially allowing its use for longer surgical procedures while maintaining the benefits of rapid postoperative recovery. This study aims to evaluate whether intravenous dexamethasone can prolong the effects of spinal anesthesia performed with chloroprocaine in adults undergoing knee arthroscopy.

Inclusion Criteria: * Undergoing knee arthroscopy lasting ≤ 40 minutes requiring spinal anesthesia (diagnostic arthroscopy or meniscal surgery), * Signed written informed consent form, * Affiliation to a social security system, * Negative pregnancy test on the day of procedure for non-menopausal patients. Exclusion Criteria: * Contraindications to spinal anesthesia with intrathecal chloroprocaine * History of diabetes, * Pre-existing peripheral neuropathy, * American Society of Anesthesiologists (ASA) physical status IV, * Contraindication to dexamethasone, * Hypersensitivity of any drug used in this study, * Long-term oral corticosteroid therapy, * Chronic opioid use, * Chronic pain syndromes, * Contraindications to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) (Ketoprofen, Celecoxib) * Need for a peripheral nerve block in addition to spinal anesthesia (e.g. knee ligamentoplasty), * Mental or linguistic inability to understand the study, * Patients under legal protection (guardianship, curatorship or safeguard of justice), * Patients currently included or planning to be included in another interventional study, * Pregnant or breastfeeding women, * Women of childbearing potential not using effective contraception.