Background and Aims:Dexamethasone as an adjuvant to bupivacaine for supraclavicular brachial plexus (SCBP) block prolongs motor and sensory blockade. However, the effect of dexamethasone (8 mg) when added to levobupivacaine has not been well studied. This study was conducted to find out analgesic efficacy of dexamethasone as adjuvant to levobupivacaine in SCBP block.Methods:Ultrasound- guided SCBP block was given to sixty patients, randomly assigned into two groups. Group S (thirty patients) received 2 mL normal saline with 25 mL levobupivacaine (0.5%) and Group D (thirty patients) received 2 mL of dexamethasone (8 mg) with 25 mL of levobupivacaine (0.5%), respectively. Time for the first rescue analgesia, number of rescue analgesics required in 24 h and different block characteristics was assessed. Chi-square test and Student's t-test were used for statistical analysis.Results:Time for request of the first rescue analgesia was 396.13 ± 109.42 min in Group S and 705.80 ± 121.46 min in Group D (P < 0.001). The requirement for rescue analgesics was more in Group S when compared to Group D. The onset of sensory and motor block was faster in Group D when compared to Group S. The mean duration of sensory and motor block was significantly longer in Group D than Group S.Conclusion:The addition of dexamethasone to levobupivacaine in SCBP blockade prolonged time for first rescue analgesia and reduced the requirement of rescue analgesics with faster onset and prolonged duration of sensory and motor block.
Background: Paravertebral block can be given for pain management after modified radical mastectomy (MRM). Although many additives to ropivacaine in PVB have been tried for post-operative analgesia, none has been found ideal. Aims and Objectives: We have compared the duration of analgesia in PVB using adjuvant like dexmedetomidine with ropivacaine after MRM. Materials and Methods: Sixty female patients posted for MRM and axillary dissection were split into two groups. Group R administered ultrasound-guided PVB with 20 ml ropivacaine 0.5% and Group RD administered 20 ml of 0.5% ropivacaine with dexmedetomidine 1 mcg/kg. After confirming PVB, surgery was done under general anesthesia in all patients. Time for 1st analgesia requirement was the main objective of our trial. Other objectives were to record visual analog scale scores and total analgesic need. Results: Post-operative analgesia duration was increased in the group RD (7.11 ± 1.42 h) in contrary to Group R (3.68 ± 1.85 h). Total paracetamol consumption post-operative 24 h was decreased in Group RD (1.63 ±0.89 g) in contrary to Group R (2.74 ± 0.76 g). Conclusion: Dexmedetomidine in PVB provides prolonged pain relief after MRM.
Introduction: Propofol a widely used anesthetic agent administered for induction and maintenance of anesthesia, post operative and ICU sedation and anticonvulsant agent. Pain on injection is a common complain during propofol administration. Many drugs like local anesthetic, opiates, esmolol, clonidine, ketamine have been tried to alleviate propofol injection pain. Here we have compared the effect of dexmedetomidine and ketamine in alleviating propofol injection pain. Materials and methods: 108 patients of either sexes, in the age groups 20-50 years, posted for routine surgical procedure under general anaesthesia were included in the study. The cases were randomly divided into 2 groups of 54 each. Group-D:-Patients received dexmedetomidine 0.5µg/kg in 20 ml Normal saline at a rate of 120 ml / hr Infused over 10 min. Group-K:- Patient received ketamine 0.5mg/kg in 20ml Normal saline at a rate of 120ml/hr infused over 10 mins. Immediately after infusion, 1% propofol in a dose of 2mg/kg IV was given over 20 seconds. Starting from the time of injection, the patients were assessed for pain by asking an open ended question, “Does it Hurts” in every 5 seconds until the patient become unresponsive. Degree of pain score was advocated by “McCririck and Hunter Scale.
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