The Effect of Adding Dexmedetomidine to Levobupivacaine for Interscalene Block for Postoperative Pain Management After Arthroscopic Shoulder Surgery

Bengisun, Züleyha Kazak; Ekmekçi, Perihan Elif; Akan, Burak; Köroğlu, Ayşegül; Tüzüner, Filiz

doi:10.1097/ajp.0000000000000065

Cited by 24 publications

(35 citation statements)

References 23 publications

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“…Studies were grouped according to dosage of dexmedetomidine. Doses greater than 50 μg 4,14,16,19,20,[25][26][27] led to a significant reduction in sensory block onset time (MD, −2.61 minutes; 95% CI, −3.93 to −1.30 minutes; I 2 = 94%; P < 0.0001); however, no significance was observed at doses 50 μg or less 17,[22][23][24]29 (MD, −5.07 minutes; 95% CI, −11.93 to 1.78 minutes; I 2 = 96%; P = 0.15). The data were also stratified according to location of the overall block.…”

Section: Sensory Block Time At Onsetmentioning

confidence: 92%

“…In regard to the type of brachial plexus block used, a total of 10 studies utilized a supraclavicular block, 4,15,18,19,[22][23][24][25]27,30 3 used an axillary block, 20,26,29 3 used an interscalene block, 14,17,21 and 2 used an infraclavicular block. 16,28 Dexmedetomidine was used as an adjuvant to several different local anesthetics, which included levobupivacaine, 17,18,20,25,28 ropivacaine, 14,19,21,23,24,27,29,30 bupivacaine, 4,15,16,22 and mepivacaine. 28 Across the studies, the dose of dexmedetomidine ranged from 0.5 μg/kg to a total of 150 μg.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…4,[15][16][17]19,20,[22][23][24][25][26][27]29 The addition of dexmedetomidine significantly reduced sensory block onset time by an average of 3.19 minutes in comparison to control (MD, −3.19 minutes; 95% CI, −4.60 to −1.78 minutes; I 2 = 95%; P < 0.00001) (Fig. 3).…”

Section: Sensory Block Time At Onsetmentioning

confidence: 99%

See 2 more Smart Citations

Investigating the Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthesia in Brachial Plexus Block

Hussain

Grzywacz

Ferreri

et al. 2017

Regional Anesthesia and Pain Medicine

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Section: Sensory Block Time At Onsetmentioning

confidence: 92%

Section: Study Characteristicsmentioning

confidence: 99%

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Investigating the Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthesia in Brachial Plexus Block

Hussain

Grzywacz

Ferreri

et al. 2017

Regional Anesthesia and Pain Medicine

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“…There have been attempts to prolong the duration of sensory block by adding different adjuvants to local anaesthetics used in interscalene brachial plexus block (IBPB), such as dexamethasone [12,13] or dexmedetomidine [14].…”

mentioning

confidence: 99%

Randomised controlled trial of analgesic effectiveness of three different techniques of single-shot interscalene brachial plexus block using 20 mL of 0.5% ropivacaine for shoulder arthroscopy

Stasiowski

Kolny

Zuber

et al. 2017

Anaesthesiol Intensive Ther

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Background: Shoulder arthroscopic procedures impose a challenge to anaesthesiologists in terms of postoperative analgesia. Proper pain management after arthroscopic procedures improves patient satisfaction and facilitates early rehabilitation. Methods: We performed a randomized, prospective clinical study to assess the influence of anthropometric parameters and IBPB technique on the quality of postoperative analgesia. A total of 106 randomly selected patients of ASA I-III status scheduled for elective shoulder arthroscopy. Reasons for exclusion were neurological deficit in the upper arm, allergies to amide-type local anesthetics, coagulopathy, and pregnancy.The patients received 20 mL of 0.5% ropivacaine for an ultrasound-guided interscalene brachial plexus block (IBPB) (group U), peripheral nerve stimulation (PNS)-confirmed IBPB (group N), or ultrasound-guided, PNS-confirmed IBPB (dual guidance; group NU). Results: We observed that the three groups did not differ in mean time of sensory and motor block terminations. In individual cases in each group, sensory block lasted up to 890-990 minutes, providing satisfactory long lasting postoperative analgesia in patients receiving IBPB. We observed a negative correlation between body mass index and termination of motor block (P = 0.037, Pearson's correlation coefficient) and a positive correlation between age and termination of sensory block (P = 0.0314, Pearson's correlation coefficient) in group U compared to the other two groups. We found a positive correlation between male gender and termination of motor block (P = 0.0487, Pearson's correlation coefficient) in group N compared to the other two groups. Conclusion: In our study, patients received satisfactory analgesia in the postoperative period regardless of technique used, age, gender, or potentially uncommon anthropometry.

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“…Single injection interscalene blockade facilitates intra-operative and short-term postoperative analgesia for these painful surgical procedures [7][8][9]. Co-administration of additive drugs such as dexmedetomidine to local anaesthetic agents is currently under investigation, but although the first clinical results are promising [10,11], they are not labelled for perineural administration, and so continuing analgesia after shoulder surgery is only currently possible using interscalene catheterisation [12].…”

Section: Introductionmentioning

confidence: 99%

A retrospective analysis of 509 consecutive interscalene catheter insertions for ambulatory surgery

Marhofer

Anderl²,

Heuberer³

et al. 2014

Anaesthesia

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SummaryEffective pain therapy after shoulder surgery is the main prerequisite for safe management in an ambulatory setting. We evaluated adverse events and hospital re-admission using a database of 509 interscalene catheters inserted during ambulatory shoulder surgery. Adverse events were recorded for 34 (6.7%) patients (9 (1.8%) catheter dislocations diagnosed in the recovery room, 9 (1.8%) catheter dislocations at home with pain, 2 (0.4%) pain without catheter dislocation, 1 (0.2%) 'secondary' pneumothorax without intervention and 13 (2.6%) other). Twelve (2.4%) patients were re-admitted to hospital (8 (1.6%) for pain, 2 (0.4%) for dyspnoea and 2 (0.4%) for nausea and vomiting), 9 of whom had rotator cuff repair. A well-organised infrastructure, optimally trained medical professionals and appropriate patient selection are the main prerequisites for the safe, effective implementation of ambulatory interscalene catheters in routine clinical practice.

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The Effect of Adding Dexmedetomidine to Levobupivacaine for Interscalene Block for Postoperative Pain Management After Arthroscopic Shoulder Surgery

Abstract: Addition of dexmedetomidine to levobupivacaine for interscalene brachial plexus block decreases pain scores and increases patient satisfaction after arthroscopic subacromial decompression.

Cited by 24 publications

References 23 publications

Investigating the Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthesia in Brachial Plexus Block

Investigating the Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthesia in Brachial Plexus Block

Randomised controlled trial of analgesic effectiveness of three different techniques of single-shot interscalene brachial plexus block using 20 mL of 0.5% ropivacaine for shoulder arthroscopy

A retrospective analysis of 509 consecutive interscalene catheter insertions for ambulatory surgery

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