Dexamethasone as a bupivacaine adjuvant for ultrasound-guided interscalene brachial plexus block: a prospective randomized study

Abstract

Background Finding adjuvants to local anesthetic used in interscalene block that could efficiently extend the analgesia duration has recently been the focus of researchers. The aim of the work was to determine whether the addition of perineural dexamethasone to bupivacaine in-ultrasound guided interscalene block would prolong the duration of sensory analgesia in patients undergoing shoulder surgery. Results This prospective, randomized, double-blinded study comprised 50 patients. They were randomly subdivided into 2 groups: group C [control] and group D [dexamethasone]. We noted a significant difference regarding the timing for the first rescue analgesia being shorter in group C than in group D with a P value < 0.001. Regarding postoperative analgesia, higher Ketolac consumption was noticed in group C than in group D. Patients from both groups showed excellent analgesic effects with VAS score less than 2 points up to 6 h postoperative then patients in group C had a higher VAS score compared to group D, and the difference was statistically significant (P value < 0.05). We also noticed an increase in the heart rate and mean arterial blood pressure in group C than in group D at 12 h and 24 h postoperatively. Conclusion We concluded that the addition of 8 mg of perineural dexamethasone to 30 ml of 0.5% bupivacaine showed improvement in the postoperative analgesia in shoulder surgery without obvious complications.

Evaluation of Analgesia Using Perineural Dexamethasone Compound in Interscalene Brachial Plexus Block After Shoulder Surgery

“…The results showed that the intensity of pain in the experimental group (dexamethasone) was lower than in the control group at 12 and 24 hours after surgery, indicating that dexamethasone was able to significantly reduce pain in patients. These findings are consistent with the results of studies by Pehora et al ( 7 ), Yayik et al ( 10 ), Badran et al ( 11 ), and Kim et al ( 12 ). For instance, Badran et al demonstrated that adding 8 mg of perineural dexamethasone to 30 cc of bupivacaine 0.5% improved postoperative pain relief in shoulder surgery without apparent side effects and prolonged the duration of the block ( 11 ).…”

“…These findings are consistent with the results of studies by Pehora et al ( 7 ), Yayik et al ( 10 ), Badran et al ( 11 ), and Kim et al ( 12 ). For instance, Badran et al demonstrated that adding 8 mg of perineural dexamethasone to 30 cc of bupivacaine 0.5% improved postoperative pain relief in shoulder surgery without apparent side effects and prolonged the duration of the block ( 11 ). They also suggested using bupivacaine with dexamethasone instead of liposomal bupivacaine ( 12 ).…”

RETRACTED: The postoperative analgesia efficacy of dexamethasone added to bupivacaine versus bupivacaine alone in ultrasound-guided supraclavicular brachial plexus block for upper limb orthopedic surgeries, Ethiopia: An observational prospective cohort study

“…2 Understanding the pathophysiology of pain, surgical procedures type, and patient factors related to increased pain, such as anxiety and depression are important for adequate control of postoperative pain. 3 Optimal management of postoperative pain is an important part of care of surgical patient, and insufficient control of pain may lead to unwanted effects, 4 such as prolonged recovery, prolonged hospital stay, and chronic pain.…”

The effect of adjuvants added to local anaesthetics for single-injection upper extremity peripheral regional anaesthesia

“…In 161 studies, patients received a supraclavicular brachial plexus block, 26,29–160 in 40 studies, patients received an axillary brachial plexus block, 24,27,161–198 in 28 studies, an interscalene block was performed, 25,199–220 in 11 studies, patients received an infraclavicular brachial plexus block, 221–231 one study used a coracoid approach to brachial plexus block 232 and one study used a suprascapular combined with axillary nerve block 233 . A detailed description of included studies is presented in the supplemental content (supplemental table 3, http://links.lww.com/EJA/A839).…”