Dexamethasone as an Adjuvant in the Axillary Echoguided Block: Prospective Single-Blind, Non-Randomized Study

Abstract

Background : Dexamethasone has been used for some years as an adjunct to local anesthetics in peripheral nerve blocks. Recently studies suggest its effectiveness in prolonging the duration of postoperative analgesia. The primary objective of this study was to evaluate the efficacy of dexamethasone as adjuvant in the axillary ultrasound guided block.Methods: Adults who required upper limb surgery in a scheduled or emergency mode were prospectively divided into two groups of 30 patients. An axillary block under ultrasound guidance was performed with an equimolar mixture of lidocaine 2%-0.5% bupivacaine associated with dexamethasone in the dexamethasone group and without dexamethasone in the control group. The evaluation of the block was done by a blind operator of the block technique. All the parameters of the nerve block as well as the delay of the demand in analgesic were noted. The study was analyzed per protocol.Results: A total of sixty patients were grouped into two equitable groups. Demographic parameters were similar between two groups. The duration and the time of installation of the axillary block were respectively 13.76min (7-30) for the control group against 12.76min (5-20) for the dexamethasone group (p = 0.27) and 11.36min (5-30) for the control group 11.66 (5-30) for the dexamethasone group (p = 0.81). The duration of sensory block was extended in the dexamethasone group by about 56% compared to the control group. The motor block was also 21.5% longer in the dexamethasone group. The delay in the use of analgesics was significantly longer in the dexamethasone group with better EVS scores compared to the control group. Plexus neuropathy was found postoperatively. Conclusion:The use of dexamethasone as an adjuvant in the axillary block prolongs postoperative analgesia in a clinically significant manner and also leads to a decrease in analgesic consumption.

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

“…The International Association of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” 1 Postoperative pain has a probability of progressing to chronic pain unless appropriately managed on time. 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.…”