Efficacy of adding ketamine, dexamethasone, and epinephrine with bupivacaine in ultrasound-guided supraclavicular brachial plexus block

Youssef, Maha; Elsayed, Sherif F.H; El-Mottalb, Enas A Abd; Tarabai, Gehan A

doi:10.4103/roaic.roaic_60_19

Cited by 3 publications

(4 citation statements)

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“…The reason for not statistically significant between groups at 1st, 2nd, and 4th hour postoperatively is due to the analgesic effects of perineural administered bupivacaine for supraclavicular block might have been persisted from 3 to 6 h. 5 After that, the plasma concentration of bupivacaine wears off. The result was consistent with a randomized double-blinded controlled study done in Egypt, 8 in which pain scores at 6th, 8th, 12th, and 24th hour were statistically significant, and Youssef et al’s 9 study showed that pain scores statistically significant at 6th, 12th, and 24th hour. This resemblance to our research, statistically significant pain scores at 6th, 8th, 12th, and 24th hour, might be related with the wear off analgesic effects in bupivacaine alone group while in the dexamethasone group, the synergetic effects of dexamethasone with bupivacaine continued.…”

Section: Discussionsupporting

confidence: 88%

“…27 Bradycardia: a decrease in HR less than 50 beats/min. 9 Nausea and vomiting: when a patient experiences ⩾1 episode of either nausea or vomiting in 24 h.…”

Section: Operational Definitionmentioning

confidence: 99%

“…6 – 8 From the different approaches to brachial plexus block, the supraclavicular approach is an easy and appropriate technique for anesthesia and analgesia in surgeries below the shoulder joint and this study evaluated it. 9 – 11 It provides greater analgesia, maintains stable intraoperative hemodynamics, reduces the stress response, and decreases anesthetic requirement and beneficial for the patients with various cardiorespiratory comorbidities. 12 , 13 Moreover, the lack of a consistent protocol among hospitals, including our hospital, on the use of particular analgesic and its effect on patient outcomes throughout hospitals, promoted us to conduct this study.…”

Section: Introductionmentioning

confidence: 99%

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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

2022

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Objectives: To compare the postoperative analgesia efficacy of dexamethasone added to low-dose high-volume bupivacaine in ultrasound-guided supraclavicular brachial plexus block for adult patients who underwent upper limb orthopedic surgeries at Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia. Methods: An observational prospective cohort study was conducted from 1 September 2021 to 30 January 2022. Using a systematic random sampling technique, 56 patients (equal groups of 28 patients) aged 18–60 years scheduled for elective upper limb orthopedic surgeries under supraclavicular block were recruited. According to the discretion of anesthetists’ management plan of supraclavicular block, those patients who received 38 mL of 0.25% bupivacaine with 2 mL (8 mg) dexamethasone as the case group (DB) while those patients who received 40 mL of 0.25% bupivacaine alone as the cohort group (B). Time to first analgesic request, onset of sensory and motor, and motor block duration were analyzed with Student’s t-test whereas pain severity and analgesic consumption were assessed using the Mann–Whitney U test. Categorical variables were analyzed using chi-square test. p-value less than 0.05 considered statistically significant. Results: Postoperative analgesia had significantly prolonged in the dexamethasone bupivacaine group with a mean duration of 1098.00 ± 195.90 min compared to 464.29 ± 113.75 min in the bupivacaine alone group, p-value < 0.001. Moreover, the dexamethasone bupivacaine group significantly consumed less total tramadol and diclofenac than bupivacaine alone, with a median dose of 0 (0–50) versus 50 (21.25–78.75) mg and 40 (0–50) versus 65 (47.50–77.50) mg, respectively. The median visual analogue scale scores were significantly reduced at 6th, 8th, 12th, and 24th hour in the dexamethasone bupivacaine group. Conclusion: Dexamethasone added to low-dose high-volume of bupivacaine in supraclavicular brachial plexus block significantly prolonged the duration of analgesia.

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Section: Discussionsupporting

confidence: 88%

“…27 Bradycardia: a decrease in HR less than 50 beats/min. 9 Nausea and vomiting: when a patient experiences ⩾1 episode of either nausea or vomiting in 24 h.…”

Section: Operational Definitionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

2022

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“…Youssef et al exploited the elastic waves generated by the rapid release of local energy within a material due to defect expansion, stress relaxation, friction, leakage, and magnetic domain wall motion. Through the acoustic emission sensor and secondary instrument measurement, the structural integrity of samples was detected and evaluated [ 9 ]. Lotfy et al proposed that the technique had been developed over the years and had made important progress in many fields, such as the safety inspection and evaluation of pressure vessels, the monitoring of welding processes and postweld integrity inspection of welds, the safety monitoring of nuclear reactors, and the research of fracture mechanics [ 10 ].…”

Section: Review Of the Literaturementioning

confidence: 99%

[Retracted] Clinical Application of Ultrasound Microscopy‐Guided Pediatric Brachial Plexus Nerve Block Anesthesia

Zhang

et al. 2022

Contrast Media & Molecular Imaging

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In order to investigate the anesthetic effect and safety of the ultrasound-guided brachial plexus block in pediatric upper limb surgery, this study retrospectively analyzed the anesthetic effect of the ultrasound-guided brachial plexus block in pediatric upper limb surgery. From January 2016 to December 2017, 82 children undergoing upper limb surgery in hospital A were selected and randomly divided into two groups by the coin method, with 41 children in each group. Ultrasound-guided brachial plexus block anesthesia and conventional anatomic localization brachial plexus block anesthesia were performed. The anesthetic drug dosage of sensory block at anesthesia completion time and motor block at onset time was compared between the two groups; the one-time puncture success rate and incidence of anesthesia complications were compared between the two groups (local anesthesia poisoning, nerve injury, pneumothorax, hematoma, and phrenic nerve palsy). The results showed that the anesthesia completion time in the study group was slightly longer than that in the control group. The sensory and motor block occurred earlier in the study group than in the control group. Low doses of narcotic drugs are used. The one-time puncture success rate of the study group was higher than that of the control group. The incidence of anesthesia complications was lower than that of the control group. The one-time puncture success rate was 92.8% in the study group and 75.7% in the control group. Ultrasound-guided brachial plexus block anesthesia has a significant effect in pediatric upper limb surgery, which can improve the anesthetic effect and reduce the incidence of complications, and is worthy of clinical promotion.

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Comparative study between ketamine-bupivacaine versus bupivacaine with intravenous ketamine infusion in supraclavicular brachial plexus block during upper limb surgeries

Soliman,

Mabood,

Mahmoud

et al. 2023

Research and Opinion in Anesthesia &Amp; Intensive Care

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Background Theb only drawback of using local anesthetics alone for supraclavicular brachial plexus block is that postoperative analgesia lasts for a shorter period. To block brachial plexus quickly and completely, different adjuvants, including opioids, dexmedetomidine, dexamethasone, midazolam, and ketamine, had been used with local anesthetics. Aim of the study was to compare the efficacy of adding ketamine to bupivacaine versus intravenous ketamine infusion with supraclavicular brachial plexus. Methods Sixty studied cases planned to undergo unilateral elective upper limb surgeries using ultrasound-guided supraclavicular brachial plexus block were separated into two groups: group 1: 20 ml bupivacaine 0.5% plus ketamine (1 mg/kg) with a maximum dose of 100 mg; (the total volume is 30 ml), with the infusion of 100 ml normal saline at a rate of 100 ml/h and group 2: 20 ml bupivacaine (0.5%) plus 10 ml saline; (the total volume is 30 ml) with the infusion of ketamine 0.15 mg/kg added to 100 ml normal saline at a rate of 100 ml/h, that was stopped 5 min before the end of surgery. Results Visual Analog Scale (VAS), heart rate and mean arterial pressure were significantly lower at 12 h postoperatively in group 1. The onset of sensory, motor block, duration of sensory and motor block were significantly lower in group 1 compared with group 2. The time of first rescue analgesia was significantly delayed in group 1 compared with group 2. Total ketorolac requirements were significantly lower in group 1. Conclusions Using ketamine bupivacaine in supraclavicular brachial plexus block in upper limb surgeries is effective in improving the onset of brachial plexus block and prolonging the time of brachial plexus block with no hemodynamic changes.

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Efficacy of adding ketamine, dexamethasone, and epinephrine with bupivacaine in ultrasound-guided supraclavicular brachial plexus block

Cited by 3 publications

References 1 publication

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

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

[Retracted] Clinical Application of Ultrasound Microscopy‐Guided Pediatric Brachial Plexus Nerve Block Anesthesia

Comparative study between ketamine-bupivacaine versus bupivacaine with intravenous ketamine infusion in supraclavicular brachial plexus block during upper limb surgeries

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