Bupivacaine In Supraclavicular Brachial Plexus Block Research Articles

A Comparitive Study Between Magnesium Sulphate Versus Dexamethasone as an Adjuvant to Bupivacaine in Supraclavicular Brachial Plexus Block

Introduction: Magnesium Sulphate and Dexamethasone are used as adjuvants to local anaesthetics inregional anaesthesia to improve the quality of blockObjective: To compare the efficacy of magnesium sulphate and dexamethasone on the characteristics of theblock and its effect on postoperative analgesia when added as an additive to bupivacaine in supraclavicularbrachial plexus block.Materials and Methods: Fifty patients belonging to American Society of Anaesthesiologists (ASA) GradeI and II, aged between 18 to 55 years, scheduled for elective upper limb surgeries under supraclavicularbrachial plexus block were enrolled in this study. Patients were equally divided into two groups : group Mreceived 0.5% Bupivacaine 30ml with 10% Magnesium sulphate 5 ml (500mg) and group D received 0.5%Bupivacaine 30ml with Dexamethasone 2ml (8mg) + Normal saline 3ml. Onset and duration of sensory andmotor block , duration of postoperative analgesia and any complications were observed.Results: In our study the demographic profile of patients, duration of surgery and ASA status between thetwo groups were comparable. Onset of sensory block was earlier in group D than group M (17.12±0.93minutes and 19.40 ±1.08 minutes respectively, p=0.001). Duration of motor block and analgesia were longerin group D as compared to group M (479.00 ±50.83 minutes vs 346.40 ±32.77 minutes respectively, p=0.001 for motor block and 533.80 ±59.80 minutes vs 415.00 ±57.23 minutes respectively, p=0.001 foranalgesia). No significant side effects were noted.Conclusion: Dexamethasone is a better adjuvant than Magnesium Sulphate when added to bupivacaine insupraclavicular brachial plexus block as it prolongs duration of motor block and analgesia significantly withminimal side effects.

Effect of Dexamethasone as an Adjuvant To 0.5% Bupivacaine in SupraclavicularBrachial Plexus Block- A Randomized Study.

Effect of Dexamethasone as an Adjuvant To 0.5% Bupivacaine in SupraclavicularBrachial Plexus Block- A Randomized Study.

Effect of addition of dexamethasone to low volumes of local anaesthetics for ultrasound-guided supraclavicular brachial plexus block

Objectives We examined the efficacy of dexamethasone as an adjuvant to low volumes of local anaesthetics in an ultrasound-guided supraclavicular brachial plexus block (SBPB). Background SBPB is an effective nerve block for use during upper limb surgery as an alternative to general anaesthesia. In addition, this block has a beneficial postoperative analgesic effect for these surgeries. Materials and methods We compared three groups of patients; each group included 30 patients scheduled for forearm and hand orthopaedic surgeries and anaesthetized by SBPB. Group A was anaesthetized by an injection of 15 ml of bupivacaine 0.5% mixed with 8 mg (2 ml) dexamethasone, group B was anaesthetized by an injection of 20 ml of bupivacaine 0.5% mixed with 8 mg (2 ml) dexamethasone and group C was anaesthetized by an injection of 20 ml of bupivacaine 0.5% mixed with 2 ml normal saline. All groups were assessed for efficacy of the block by assessment of the onset and duration of sensory and motor block and assessment of the quality and duration of postoperative analgesia. All groups were assessed for the incidence of complications. Results The addition of dexamethasone to low volumes of bupivacaine in SBPB significantly hastened the onset and prolonged the duration of sensory and motor block. Dexamethasone yielded better quality of postoperative analgesia with lower levels of the visual analogue scale; also, it led to a statistically significantly longer duration of postoperative analgesia with lower analgesic consumption, and these effects were more prominent in group B with a slightly higher volume of bupivacaine. There were very few incidences of complications among the three groups. Conclusion The addition of dexamethasone to low volumes of bupivacaine in ultrasound-guided SBPB significantly decreased the onset time and prolonged the duration of sensory and motor blockade; also, it prolonged the duration and improved the quality of postoperative analgesia, with very few incidences of complications.