Evaluation Of Analgesic Effect Of Two Different Doses Of Dexamethasone As An Adjuvant To 0.5% Bupivacaine In Ultrasound Guided Supraclavicular Brachial Plexus Block- A Randomized Double Blinded Controlled Study
DOI:
https://doi.org/10.63682/jns.v14i8S.2986Keywords:
Dexamethasone, 0.5% Bupivacaine, analgesia, ultrasound and supraclavicular blockAbstract
Introduction: Pain is a major problem in perioperative care. Supplementation of adjuvant along with local anaesthetic agent escalates the duration of analgesia in supraclavicular brachial plexus block and also decreases the requirements of intravenous analgesics. Comparison of the two different doses of Dexamethasone as an adjuvant to Bupivacaine was done for post operative pain management in ultrasound-guided Supraclavicular brachial plexus block.
Aim: The aim of the study was to evaluate and compare the duration of analgesia with two different doses of Dexamethasone (8mg Vs 4 mg) as an adjuvant to Bupivacaine in ultrasound-guided supraclavicular brachial plexus block.
Materials and methods: A randomized comparative double-blinded study was conducted in Thirty-six patients of age 18-65 years of ASA Ⅰ & Ⅱ scheduled for upper limb surgery under US-guided Supraclavicular brachial plexus block and were divided into three groups consisting of 12 patients each, Group D8 received 20 ml of 0.5% Bupivacaine and 2 ml of Dexamethasone 8 mg, Group D4 Patients received 20 ml of 0.5% Bupivacaine with 1ml normal saline (NS) and 1ml Dexamethasone 4 mg (Total volume of 22 ml) and Group B received 20 ml of 0.5% Bupivacaine with 2 ml (NS) (Total volume 22 ml). Duration of postoperative analgesia was recorded by using 100 points visual analogue scale (VAS).
Results: Demographic and surgical characteristics were similar in all three groups. Mean ± SD of duration of analgesia in group D8 was 1021.17 ± 251.19 minutes which was significantly higher as compared to groups D4 (688.5 ± 174.41 minutes, p value<.0001) and group B (523 ± 84.59 minutes, p value<.0001). Duration of analgesia in D4 was also significantly higher as compared to group B (p=0.034).
Conclusion: It is concluded that Inj Dexamethasone 8 mg as adjuvant to Bupivacaine significantly increases the duration of analgesia as compared to Dexamethasone 4 mg in ultrasound guided supraclavicular brachial plexus block.
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Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. The Lancet. 2006;367:1618-25.
Kohli S, Kaur M, Sahoo S, Vajifdar H, Kohli P. Brachial plexus block: Comparison of two different doses of clonidine added to bupivacaine. J Anaesthesiol Clin Pharmacol. 2013;29:491-5.
Pathak RG, Satkar AP, Khade RN. Supraclavicular brachial plexus block with and without dexamethasone–a comparative study. Int J Sci Res Publ. 2012;2:1-7.
Abdallah FW, Johnson J, Chan V, Murgatroyd H, Ghafari M, Ami N, et al. Intravenous dexamethasone and perineural dexamethasone similarly prolong the duration of analgesia after supraclavicular brachial plexus block: a randomized, triple-arm, double-blind, placebo-controlled trial. Reg Anesth Pain Med. 2015;40(2):125-32.
Baloda R, Bhupal JP, Kumar P, Gandhi GS. Supraclavicular brachial plexus block with or without dexamethasone as an adjuvant to 0.5% levobupivacaine: a comparative study. J Clin Diagn Res:2016;10:UC09- UC12.
Woo JH, Kim YJ, Kim DY, Cho S. Dose-dependency of dexamethasone on the analgesic effect of interscalene block for arthroscopic shoulder surgery using ropivacaine 0.5%: a randomised controlled trial. Eur J Anaesth. 2015;32(9):650-5.
Kirkham KR, Jacot-Guillarmod A, Albrecht E. Optimal Dose of Perineural Dexamethasone to Prolong Analgesia After Brachial Plexus Blockade: A Systematic Review and Meta-analysis. Anesth Analg. 2018;126:270-9.
Tandoc MN, Fan L, Kolesnikov S, Kruglov A, Nader ND. Adjuvant dexamethasone with bupivacaine prolongs the duration of interscalene block: a prospective randomized trial. J Anesth. 2011;25:704-9.
Kantharaja HE, Nagaraj B, Thejesh HJ. A comparative study of dexamethasone versus midazolam as adjuvant to 0.5% bupivacaine in ultrasound-guided supraclavicular brachial plexus block for upper-limb surgeries. Anesth, Essays Res. 2020;14:183-8.
Mathew R, Radha KR, Hema VR. Effect of perineural and intravenous dexamethasone on duration of analgesia in supraclavicular brachial plexus block with bupivacaine: a comparative study. Anesth, Essays Res. 2019;13:280-3
Trabelsi W, Lebbi A, Romdhani C, Naas I, Sammoud W, Elaskri H. Dexamethasone provides longer analgesia than tramadol when added to lidocaine after ultrasound guided supraclavicular brachial plexus block. A randomized, controlled, double blinded study. Analg Resusc. 2013;2:2.
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