A randomized prospective study of the efficacy of dexamethasone or clonidine as an additive to local anaesthetic for supraclavicular block for upper limb surgeries in a tertiary care hospital
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 9, Issue 2
Abstract
Background: Supraclavicular brachial plexus block is one of the most regular techniques of regional anaesthesia employed for upper limb surgeries. In observation of prolonging the sensory block and duration of block, different adjuvants have been tried with varying degrees of success. Dexamethasone and Clonidine are two such adjuvants which have been established to be suitable as adjuvants in various studies. The practice of combining additives to local anaesthetics used in peripheral nerve blocks carries lot of advantages. We compared the outcome of dexamethasone or clonidine as adjuvant to local anaesthetic in supraclavicular brachial plexus block in an attempt to obtain the better adjuvant amongst both. Methods: In this prospective, randomized study, 2 groups of 30patients each were investigated, using 10 ml 2% lignocaine with 1:200000 adrenaline and 20 ml 0.5% bupivacaine with 8mg dexamethasone for group1. Group 2 received 10 ml 2% lignocaine with 1:200000 adrenaline and 20 ml 0.5% bupivacaine with 0.150 mg clonidine. The observed parameters were onset of sensory and motor blockade, the duration of analgesia and occurrence of any side effects. Data were subjected to statistical analysis using open epi.com. Student t test was used to analyse the quantitative variables. Qualitative variables were analyzed using Chi square test. P < 0.05 was considered statistically significant. Results: the onset of sensory block was 7.63+4.14 in group 1 and 9.36+2.58 minutes in Group 2 respectively. Mean onset of motor block was 7.98+3.12 Groups 1 and 10.52+3.61 minutes in Group 2 respectively. Duration of analgesia in Groups 1 and Group 2 were 798.2+378.5 and 679.3+354.5 minutes respectively. There was no major side effects were noted in two groups. Conclusion: Dexamethasone might be a superior additive to local anaesthetic than clonidine in supraclavicular block as it produces earlier onset of sensory and motor block. Longer duration of analgesia was also noted, though the variation is not statistically significant in this study.
Authors and Affiliations
Pradeep Kumar Das, Pratheek R Reddy, M Madhu Chaitanya
Keywords
Related Articles
- EP ID EP521073
- DOI 10.26611/10159213
- Views 159
- Downloads 0
Comparison of I-gel versus proseal laryngeal mask airway (PLMA) for elective surgical elective surgical procedures
Background:Securing airway of patient during surgery is one of the most important responsibility of anesthesiologist.Though Endotracheal Tube is gold standard for securing airway during general anesthesia, various suprag...
Evaluation of the hemodynamic effect of bupivacaine wound instillation in modified radical mastectomy
Background and aim: Breast cancerare a leading cause of cancer death among women. Modified Radical Mastectomy (MRM) is the commonest surgery done for operable breast malignancies. Majority of operated patients will exper...
A comparative study of effectiveness of video laryngoscopy and direct laryngoscopy in patients with at least three predictors of difficult intubation
Background: Difficulty in achieving a patent airway depends mainly on anatomical factors which play a predominant role in deciding the degree of difficult airway. The identification of the patients with difficult airway...
Airway management and anaesthesia in maxillofacial trauma
Maxillofacial trauma forms a major part of patients attending emergency department because of the frequency and abundant occurrence. Management of airway is pivotal due to distorted anatomy, urgency of establishing airwa...
Effect of spinal anaesthesia on perioperative hyperglycemia in diabetic patients undergoing lower limb orthopaedic surgeries
Background and Aims: Surgery evokes stress response resulting in increased secretion of counter-regulatory hormones (catecholamines, cortisol, glucagon, and growth hormone) and excessive release of inflammatory cytokines...