Baloda Ritu, Bhupal Jatinder Paul Singh, Kumar Parmod, Gandhi Gurjit Singh
Junior Resident, Department of Anaesthesia, Government Medical College, Rajindra Hospital , Patiala, Punjab, India .
Professor and Head, Department of Anaesthesia, Government Medical College, Rajindra Hospital , Patiala, Punjab, India .
J Clin Diagn Res. 2016 Jun;10(6):UC09-12. doi: 10.7860/JCDR/2016/18325.8048. Epub 2016 Jun 1.
Brachial plexus block is an excellent method for attaining optimal operating conditions by producing complete muscular relaxation, maintaining stable intraoperative haemodynamics and the associated sympathetic block. In addition, they provide extended postoperative analgesia with minimal side effects. Different adjuvants have been described in literature to hasten the onset and prolong the duration of block. The present study was conducted to study the effect of adding dexamethasone to levobupivacaine in supraclavicular brachial plexus block.
To observe the effect of dexamethasone on onset and duration of anaesthesia, when used as an adjuvant to levobupivacaine in supraclavicular brachial plexus block.
A total of 60 patients in the age group of 18-65 years belonging to ASA physical status I or II were included in the study. They are randomly allocated in two groups and each group included 30 patients. In group 1, patients received 30ml of 0.5% isobaric levobupivacaine with 2ml of isotonic sodium chloride. In group 2 patients received 8mg (2ml) dexamethasone in addition to 30ml of 0.5% isobaric levobupivacaine.
The results showed that the onset of sensory and motor block were faster in group 2(p<0.05). The duration of sensory and motor block were significantly longer in group 2 (p<0.05). VAS score at 12 hours were significantly lower in group 2 (p<0.05). None of the patients had bradycardia, hypotension or any other side effects.
Dexamethasone added to levobupivacaine for supraclavicular brachial plexus block reduces the time to onset of sensory and motor blockage and prolongs the duration of analgesia.
臂丛神经阻滞是一种通过产生完全肌肉松弛、维持术中血流动力学稳定以及相关交感神经阻滞来实现最佳手术条件的优秀方法。此外,它们能提供副作用最小的术后延长镇痛。文献中描述了不同的佐剂以加速阻滞起效并延长阻滞持续时间。本研究旨在探讨在锁骨上臂丛神经阻滞中向左旋布比卡因中添加地塞米松的效果。
观察地塞米松作为锁骨上臂丛神经阻滞中左旋布比卡因佐剂时对麻醉起效和持续时间的影响。
本研究纳入了60例年龄在18 - 65岁、ASA身体状况为I或II级的患者。他们被随机分为两组,每组30例患者。第1组患者接受30ml 0.5%等比重左旋布比卡因加2ml等渗氯化钠。第2组患者除接受30ml 0.5%等比重左旋布比卡因外,还接受8mg(2ml)地塞米松。
结果显示,第2组感觉和运动阻滞的起效更快(p<0.05)。第2组感觉和运动阻滞的持续时间显著更长(p<0.05)。第2组12小时时的视觉模拟评分(VAS)显著更低(p<0.05)。所有患者均未出现心动过缓、低血压或任何其他副作用。
在锁骨上臂丛神经阻滞中向左旋布比卡因中添加地塞米松可缩短感觉和运动阻滞的起效时间并延长镇痛持续时间。