Interscalene block for double fracture of right hand using bupivicaine and lidocaine with dexamethasone

Abstract

Background and Aims:The analgesic effect of an interscalene block with bupivicaine and lidocaine in a mixture ratio:1:1 with dexamethasone intravenously Methods:A 68 years old female was admitted and scheduled for an urgent operation because she was in visit in Lebanon and had to leave for her country. She had a double fracture in the right upper limb: clavicular and elbow fractures. An interscalene block was done using bupivicaine 0.5%-20ml and lidocaine 2%-20ml in 2 syringe of 20ml mixed together then 8mg of dexamethasone was given intravenously. After the settling of the block the patient was intubated given 2mg of midazolam 50mcg of fentanyl 100mg of propofol and 8mg of nimbex. Patient was in back rest position and the maintenance was by sevoflurane ResultsThe operation took 6 hours. The blood pressure was between 95 and 85 mm hg for the systolic and 65 to 50mm hg for the diastolic the heart rate was between 62 and 65 beat by min. No fentanyl was added. After the extubation the patient was in the recovery room for 30 min then sending her to the wards. She didn't take any analgesia in the recovery room the EVA was <40. After 4 hours she didn't need any analgesia and after 3 hours she went home without no pain. Conclusions:An ISB with bupivicaine and lidocaine in a mixture of 1:1 with 8 mg of dexamethasone iv gives a good analgesic effect more then 8 hours