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Supraclavicular brachial plexus block with and without dexamethasone as an adjuvant to local anesthetics - An observational study

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Original Article

Author Details : Sunita Y Shende, Ujwala B Khairmode, Rupali N Gorgile, Radhika M Marathe*

Volume : 7, Issue : 4, Year : 2020

Article Page : 645-651

https://doi.org/10.18231/j.ijca.2020.116

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Abstract

Background: Brachial plexus block with bupivacaine provides very effective intraoperative anaesthesia and also analgesia. It was found that when dexamethasone was added as an additive to bupivacaine, it increases the duration of anaesthesia and also the duration of analgesia. This study was carried out to compare onset and duration of sensory and motor blockade and duration of postoperative analgesia on addition of dexamethasone to local anestheic and local anesthetic alone in supraclavicular brachial plexus block.
Materials and Methods: After obtaining the approval from the Institutional Ethical committee and written informed consent from the patients, 60 patients were included in our study.
We included 60 ASA I & II patients who were aged between 18 years & 60 years, underwent elective upper limb surgeries. They were divided into two equal groups.
Group 1 (cases) who received 15 milliliter of 2% lignocaine with adrenaline and 15 milliliter of 0.5% bupivacaine + dexamethasone 8mg(2ml).
Group 2 (controls) who received 15 milliliter of 2% lignocaine with adrenaline and 15 milliliter of 0.5% bupivacaine + 0.9% normal saline(2ml).
We observed the Onset of sensory and motor blockade, duration of sensory and motor blockade and postoperative analgesia between the two groups.
Results: The onset of sensory blockade was within 7.3 min in group 1. In group 2 the onset of sensory blockade was 13.66 minutes.
The onset of motor blockade was within 3.93 min in group 1. In group 2 the onset of motor blockade was 18.66 min.
The duration of intra operative analgesia was 654.33 minutes in group 1. In group 2 the duration of intra operative analgesia was 292.6 minutes.
The duration of post operative analgesia was 815±13.57 minutes in group 1. The duration of post operative analgesia in group 2 was 393.8±42.88 minutes.
There were no complications in both the groups in intra operative period and post operative period.
Conclusion: Dexamethasone, when added to 15 millilitre of 0.5% bupivacaine and 15 millilitre of 2% lignocaine plus adrenaline, very effectively enhances the onset of sensory and motor blockade. It dramatically prolongs the duration of sensory and motor blockade and duration of analgesia. There were no untoward side effects with the use of dexamethasone as an additive in the brachial plexus block.

Keywords: Brachial plexus block, Dexamethasone, Supraclavicular block, Analgesia.

How to cite : Shende S Y , Khairmode U B, Gorgile R N, Marathe R M, Supraclavicular brachial plexus block with and without dexamethasone as an adjuvant to local anesthetics - An observational study. Indian J Clin Anaesth 2020;7(4):645-651

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