A clinical comparison between 0.5% levobupivacaine and 0.5% levobupivacaine with dexamethasone 8 mg combination in brachial plexus block by the supraclavicular approach

Pani, Nibedita; Routray, Sidharth Sraban; Mishra, Debasis; Pradhan, Basant; Mohapatra, Bishnu Prasad; Swain, Deepti

doi:10.4103/ija.ija_509_16

Cited by 21 publications

(18 citation statements)

References 21 publications

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“…[ 16 ] In another study, use of 8 mg dexamethasone along with 0.5% levobupivacaine in SCBP block lead to reduced demand of rescue analgesics with brisk onset of block and extended sensory and motor block duration. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

“…Dexamethasone as adjuvant to perineural local anaesthetics augments peripheral nerve block analgesia. [ 4 5 ] Dexmedetomidine, an alpha-adrenergic agonist when mixed with LAs for brachial plexus block facilitates better anaesthesia and analgesia. [ 6 ] The chase for quintessential adjuvant with most benefits and minimal side-effects continues.…”

Section: Introductionmentioning

confidence: 99%

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Dexmedetomidine vs dexamethasone as an adjuvant to 0.5% ropivacaine in ultrasound-guided supraclavicular brachial plexus block

Singh

Gupta

Kathuria

2020

J Anaesthesiol Clin Pharmacol

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Background and Aims: Both dexmedetomidine and dexamethasone have individually been shown to be beneficial as an adjuvant to ropivacaine. We compared the efficacy of combination of ropivacaine with dexmedetomidine and ropivacaine with dexamethasone in ultrasound-guided supraclavicular brachial plexus (SCBP) block. Material and Methods: In this prospective randomised double-blind controlled trial, 60 ASA physical status I/II patients undergoing elective upper-limb surgery under ultrasound-guided SCBP block with 30 ml of 0.5% ropivacaine were randomised into three groups. Group 1 ( n = 20) received 1 μg/kg of dexmedetomidine, and group 2 ( n = 20) received 8 mg of dexamethasone in addition to ropivacaine, while group 3 ( n = 20) received only ropivacaine. The primary outcomes studied were onset and duration of sensory and motor block. Secondary outcomes included duration of analgesia, total analgesic consumption in 24 h postoperatively and quality of block. ANOVA and Chi-square test were used to compare results on continuous measurements and categorical measurements, respectively. Results: Onset of sensory and motor block was faster in group 1 (13.5 ± 4.1 and 17.0 ± 4.1 min) and group 2 (15.6 ± 3.6 and 18.5 ± 3.7 min) as compared to group 3 (20.1 ± 5.3 and 24.9 ± 5.6 min; P < 0.001). Block duration was significantly longer in group 1 and group 2 than in group 3. Duration of analgesia was prolonged in group 1 and 2 (1218.0 ± 224.6 and 1128.0 ± 207.5 min, respectively) as compared to group 3 (768.0 ± 273.7 min; P < 0.001). Twenty-four hours analgesic consumption postoperatively was reduced in the two study groups. Conclusion: Both dexmedetomidine and dexamethasone when used as adjuvants to ropivacaine for SCBP block, block onset time, and prolong' block duration.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine vs dexamethasone as an adjuvant to 0.5% ropivacaine in ultrasound-guided supraclavicular brachial plexus block

Singh

Gupta

Kathuria

2020

J Anaesthesiol Clin Pharmacol

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“…Use of dexamethasone as an adjuvant to local anaesthetics in brachial plexus block has been reported to prolong duration of analgesia. [ 6 15 ] A recent systematic review has shown that dexamethasone when used along with local anaesthetic significantly reduces the VAS score and analgesic consumption. However, the duration of significant relief is variable.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] When compared with direct administration of opioids, use of gelfoam soaked in opioids in epidural space prolongs the effect of epidural opioid. [ 5 ] Dexamethasone as an adjuvant to local anaesthetic in brachial plexus block results in prolonged duration of analgesia,[ 6 ] but search of the available literature revealed no study comparing the analgesic efficacy of dexamethasone as an adjuvant to epidural levobupivacaine in laminectomy surgery.…”

Section: Introductionmentioning

confidence: 99%

Effect of epidural levobupivacaine with or without dexamethasone soaked in gelfoam for postoperative analgesia after lumbar laminectomy: A double blind, randomised, controlled trial

et al. 2018

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Background and Aims:Postoperative pain results in prolonged hospital stay and delayed return to normal activity. This study was conducted with the aim of evaluating the analgesic efficacy of gelfoam soaked in levobupivacaine with or without dexamethasone placed in the epidural space in patients undergoing lumbar laminectomy.Methods:Ninety adult patients were randomised into three groups. Gelfoam was soaked in 12 mL of 0.9% sodium chloride in Group P, 10 mL of 0.25% levobupivacaine + 2 mL of 0.9% sodium chloride in Group L, and 10 mL of 0.25% levobupivacaine + 2 mL of dexamethasone in group LD. The primary outcome was time to first request for rescue analgesia. Total 24-h tramadol consumption, and postoperative visual analog scale (VAS) scores were recorded. Chi-square test and analysis of variance test were used, and P < 0.05 was considered significant.Results:75 patients completed the study. Time to first rescue analgesia was longer in group LD [10.11 ± 3.10 h] compared with group L [6.48 ± 2.36 h] and group P [1.76 ± 1.13 h]. Total 24-h tramadol consumption was lower in group LD (88 ± 66.58 mg) and group L (120 ± 70.7 mg) compared with group P (280 ± 64.5 mg). Postoperative VAS scores were lower in group LD and group L compared with group P, both at rest and on movement.Conclusion:Epidural gelfoam soaked in levobupivacaine and dexamethasone prolongs the duration of analgesia and decreases rescue analgesic consumption and VAS score postoperatively, in patients undergoing lumbar laminectomy.

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“…Recent studies have examined whether intravenous dexamethasone provides similar block prolongation compared to perineural administration. [ 41 ] Rahangdale et al . compared dexamethasone 8 mg given intravenously or through perineural injection in sciatic nerve blockade to placebo.…”

Section: Adjuvants To Regional Anaesthesiamentioning

confidence: 99%

Advances in regional anaesthesia: A review of current practice, newer techniques and outcomes

2018

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Advances in ultrasound guided regional anaesthesia and introduction of newer long acting local anaesthetics have given clinicians an opportunity to apply novel approaches to block peripheral nerves with ease. Consequently, improvements in outcomes such as quality of analgesia, early rehabilitation and patient satisfaction have been observed. In this article we will review some of the newer regional anaesthetic techniques, long acting local anaesthetics and adjuvants, and discuss evidence for key outcomes such as cancer recurrence and safety with ultrasound guidance.

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A clinical comparison between 0.5% levobupivacaine and 0.5% levobupivacaine with dexamethasone 8 mg combination in brachial plexus block by the supraclavicular approach

Cited by 21 publications

References 21 publications

Dexmedetomidine vs dexamethasone as an adjuvant to 0.5% ropivacaine in ultrasound-guided supraclavicular brachial plexus block

Dexmedetomidine vs dexamethasone as an adjuvant to 0.5% ropivacaine in ultrasound-guided supraclavicular brachial plexus block

Effect of epidural levobupivacaine with or without dexamethasone soaked in gelfoam for postoperative analgesia after lumbar laminectomy: A double blind, randomised, controlled trial

Advances in regional anaesthesia: A review of current practice, newer techniques and outcomes

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