A clinical comparison between 0.5% levobupivacaine and 0.5% levobupivacaine with dexamethasone 8 mg combination in brachial plexus block by the supraclavicular approach
- PMID: 28515517
- PMCID: PMC5416719
- DOI: 10.4103/ija.IJA_509_16
A clinical comparison between 0.5% levobupivacaine and 0.5% levobupivacaine with dexamethasone 8 mg combination in brachial plexus block by the supraclavicular approach
Abstract
Background and aims: Dexamethasone as an adjuvant to bupivacaine for supraclavicular brachial plexus (SCBP) block prolongs motor and sensory blockade. However, the effect of dexamethasone (8 mg) when added to levobupivacaine has not been well studied. This study was conducted to find out analgesic efficacy of dexamethasone as adjuvant to levobupivacaine in SCBP block.
Methods: Ultrasound- guided SCBP block was given to sixty patients, randomly assigned into two groups. Group S (thirty patients) received 2 mL normal saline with 25 mL levobupivacaine (0.5%) and Group D (thirty patients) received 2 mL of dexamethasone (8 mg) with 25 mL of levobupivacaine (0.5%), respectively. Time for the first rescue analgesia, number of rescue analgesics required in 24 h and different block characteristics was assessed. Chi-square test and Student's t-test were used for statistical analysis.
Results: Time for request of the first rescue analgesia was 396.13 ± 109.42 min in Group S and 705.80 ± 121.46 min in Group D (P < 0.001). The requirement for rescue analgesics was more in Group S when compared to Group D. The onset of sensory and motor block was faster in Group D when compared to Group S. The mean duration of sensory and motor block was significantly longer in Group D than Group S.
Conclusion: The addition of dexamethasone to levobupivacaine in SCBP blockade prolonged time for first rescue analgesia and reduced the requirement of rescue analgesics with faster onset and prolonged duration of sensory and motor block.
Keywords: Dexamethasone; levobupivacaine; supraclavicular brachial plexus.
Conflict of interest statement
There are no conflicts of interest.
Figures
Similar articles
-
Effect of Dexamethasone on Characteristics of Supraclavicular Nerve Block with Bupivacaine and Ropivacaine: A Prospective, Double-blind, Randomized Control Trial.Anesth Essays Res. 2018 Jan-Mar;12(1):234-239. doi: 10.4103/aer.AER_2_18. Anesth Essays Res. 2018. PMID: 29628588 Free PMC article.
-
A Comparative Study of Effect of 0.25% Levobupivacaine with Dexmedetomidine versus 0.25% Levobupivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block.Anesth Essays Res. 2021 Oct-Dec;15(4):443-447. doi: 10.4103/aer.aer_145_21. Epub 2022 Mar 30. Anesth Essays Res. 2021. PMID: 35422557 Free PMC article.
-
Effect of Locally Administered Dexmedetomidine as Adjuvant to Levobupivacaine in Supraclavicular Brachial Plexus Block: Double-blind Controlled Study.Anesth Essays Res. 2017 Oct-Dec;11(4):981-986. doi: 10.4103/aer.AER_55_17. Anesth Essays Res. 2017. PMID: 29284860 Free PMC article.
-
Comparison of Perineural and Intravenous Dexamethasone as an Adjuvant to Levobupivacaine in Ultrasound-Guided Infraclavicular Brachial Plexus Block: A prospective Randomized Trial.Anesth Essays Res. 2021 Jan-Mar;15(1):45-50. doi: 10.4103/aer.aer_69_21. Epub 2021 Aug 30. Anesth Essays Res. 2021. PMID: 34667347 Free PMC article.
-
Perineural dexamethasone added to local anesthesia for brachial plexus block improves pain but delays block onset and motor blockade recovery.Pain Physician. 2015 Jan-Feb;18(1):1-14. Pain Physician. 2015. PMID: 25675053 Review.
Cited by
-
Adjuvant Drugs for Peripheral Nerve Blocks: The Role of Alpha-2 Agonists, Dexamethasone, Midazolam, and Non-steroidal Anti-inflammatory Drugs.Anesth Pain Med. 2021 Jul 4;11(3):e117197. doi: 10.5812/aapm.117197. eCollection 2021 Jun. Anesth Pain Med. 2021. PMID: 34540647 Free PMC article. Review.
-
Dexamethasone Does not Compensate for Local Anesthetic Cytotoxic Effects on Tenocytes: Morphine or Morphine Plus Dexamethasone May Be a Safe Alternative.Arthrosc Sports Med Rehabil. 2021 Dec 23;4(2):e459-e469. doi: 10.1016/j.asmr.2021.11.004. eCollection 2022 Apr. Arthrosc Sports Med Rehabil. 2021. PMID: 35494256 Free PMC article.
-
Effects of 4 mg and 8 mg Dexamethasone Added to Intrathecal Bupivacaine on Perioperative Analgesia Among Adult Orthopedic Patients at Sodo Christian Hospital: A Prospective Cohort Study.Pain Res Manag. 2024 Oct 30;2024:8872988. doi: 10.1155/2024/8872988. eCollection 2024. Pain Res Manag. 2024. PMID: 39512893 Free PMC article. Clinical Trial.
-
Effect of epidural levobupivacaine with or without dexamethasone soaked in gelfoam for postoperative analgesia after lumbar laminectomy: A double blind, randomised, controlled trial.Indian J Anaesth. 2018 Jul;62(7):509-515. doi: 10.4103/ija.IJA_128_18. Indian J Anaesth. 2018. PMID: 30078853 Free PMC article.
-
Our Ultrasound Guided Brachial Plexus Block Experiences for Upper Extremity Surgeries in Pediatric Patients.Sisli Etfal Hastan Tip Bul. 2020 Jun 1;54(2):231-235. doi: 10.14744/SEMB.2018.98958. eCollection 2020. Sisli Etfal Hastan Tip Bul. 2020. PMID: 32617065 Free PMC article.
References
-
- Movafegh A, Razazian M, Hajimaohamadi F, Meysamie A. Dexamethasone added to lidocaine prolongs axillary brachial plexus blockade. Anesth Analg. 2006;102:263–7. - PubMed
-
- Cummings KC, 3rd, Napierkowski DE, Parra-Sanchez I, Kurz A, Dalton JE, Brems JJ, et al. Effect of dexamethasone on the duration of interscalene nerve blocks with ropivacaine or bupivacaine. Br J Anaesth. 2011;107:446–53. - PubMed
LinkOut - more resources
Full Text Sources
Other Literature Sources