Comparative study of ropivacaine alone versus ropivacaine with dexamethasone in supraclavicular brachial plexus block
DOI:
https://doi.org/10.18203/2349-2902.isj20175100Keywords:
Dexamethasone, Ropivacaine, Supraclavicular brachial blockAbstract
Background: Brachial plexus block is often used either as an adjuvant to general anesthesia (GA) or as a sole anesthesia modality. Supraclavicular brachial plexus block is preferred for its rapid onset, reliable anesthesia and as a safe technique for any surgery in the upper extremity that does not involve the shoulder. We have attempted to undertake this study to compare the haemodynamic, sensory and motor effects of the anaesthetic effect of Ropivacaine alone and Ropivacaine along with Dexamethasone in Supraclavicular Brachial Block in upper limb surgery.
Methods: The total duration of surgery was also comparable in both groups. The onset of the sensory and the motor block in bother the groups were similar to each other with no statistical difference, but there was a very high significance in the duration of both sensory and motor block within both the groups.
Results: The total duration of surgery was also comparable in both groups. The onset of the sensory and the motor block in bother the groups were similar to each other with no statistical difference, but there was a very high significance in the duration of both sensory and motor block within both the groups.
Conclusions: Dexamethasone added to ropivacaine in supraclavicular brachial block for upper limb surgery significantly shortens the onset time and prolongs the duration of sensory and motor blocks without producing sedation in patients.
Metrics
References
McCartney CJ, Brull R, Chan VW, Katz J, Abbas S, Graham B, et al. Early but no long-term benefit of regional compared with general anesthesia for ambulatory hand surgery. Anesthesiology. 2004;101:461-7.
Edward G Morgan, Maged S Mikhail, Murray MJ. Peripheral nerve blocks, 4th ed. Chapter 17. In: Clinical anaesthesiology, New Delhi: Tata McGraw-Hill; 2009.
Kumar S, Palaria U, Sinha AK, Punera DC, Pandey V. Comparative evaluation of ropivacaine and ropivacaine with dexamethasone in supraclavicular brachial plexus block for postoperative analgesia. Anesth Essays Res. 2014;8(2):202-8.
Hansen TG. Ropivacaine: A pharmacological review. Expert Rev Neurother. 2004;4:781-91.
Choyce A, Peng P, A systemic review of adjuvants for intravenous regional anaesthesia for surgical procedures. Can J Anesh. 2002;49(1):32-45.
Sauerland S, Nagelschmidt M, Mallmann P, Neugebauer EA. Risks and benefits of preoperative high dose methylprednisolone in surgical patients: a systematic review. Drug Saf. 2000;23:449-61.
Schulze S, Andersen J, Overgaard H, et al. Effect of prednisolone on the systemic response and would healing after colonic surgery. Archives Surg. 1997;132:129-35.
Attardi B, Takimoto K, Gealy R, Severns C, Levitan ES. Glucocorticoid induced up- regulation of a pituitary K+ channel mRNA in vitro and in vivo. Receptors Channels 1993;1:287-93.
Kopacz DJ, Lacouture PG, Wu D, Nandy P, Swanton R, Landau C. The dose response and effects of dexamethasone on bupivacaine microcapsules for intercostal blockade (T9 to T11) in healthy volunteers. Anesth Analg. 2003;96:576-82.
Moore D: Supraclavicular approach for block of the brachial plexus, in Moore D, (ed): Regional block. A handbook for use in the clinical practice of medicine and surgery, 4th ed. Springfield, Charles C Thomas Publisher, 1981:221-242.
Bromage PR and Gertel M. Improved Brachial Plexus Blockade with Bupivacaine Hydrochloride and Carbonated Lidocaine. Anesthesiology. 1972;36:479-87.
Golwala MP, Swadia VN, Dhimar AA, Sridhar NV. Pain relief by dexamethasone as an adjuvant to local anaesthetics in supraclavicular brachial plexus block. J Anaesth Clin Pharmacol. 2009;25(3):285-8.
Cummings KC, 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. British J Anaesthesia. 2011:107(3):446-53.
Casati A, Fanelli G, Aldegheri G, Berti M, Colnaghi E, Cedrati V, et al. Interscalene brachial plexus anaesthesia with 0.5%, 0.75% or 1% Ropivacaine: a double-blind comparison with 2% mepivacaine. Br J Anaesth. 1999;83:872-5.
Parrington SJ, O'donnell D, Chan VW, Brown-Shreves D, Subramanyam R, Qu M, et al. Dexamethasone added to mepivacaine prolongs the duration of analgesia after supraclavicular brachial plexus blockade. Regional Anesthesia Pain Medicine. 2010;35(5):422-6.