Evaluation of Post Operative Analgesia on Adding Dexamethasone with Ropivacaine in Interscalene Brachial Plexus Block for Shoulder Surgery
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 9
Abstract
Background and Objectives: Dexamethasone as an adjuvant to ropivacaine for interscalene brachial plexus (ISBP) block prolongs duration of analgesia . However, this study was conducted to further substantiate analgesic efficacy of dexamethasone as an adjuvant to ropivacaine in ISBP block for shoulder surgeries.Methods :After taking hospital ethical clearance and written informed consent from patients,nerve stimulator guided ISBP block was given to 100 patients , randomly assigned to one of two groups: (N=50 in each group). Group R (ropivacaine ) received 30 ml (0.5%) ropivacaine + 2 ml saline and group RD ( ropivacaine – dexamethasone ) received 30 ml (0.5%) ropivacaine + dexamethasone 8 mg . Duration of analgesia, onset of sensory and motor block, VAS score, 24 hour analgesic requirement were recorded and compared. Computer software SPSS version‑ 16 (SPSS Inc., Chicago, Illinois, USA) was used for statistical analysis. Chi‑ square test and Student’s t‑ test were used and P < 0.05 was considered as significant. Results: The mean duration of analgesia in Group RD was 1211.83±32.86 min and in Group R it was 283.17.±7.71 min (P = 0.0001). Onset of sensory block in Group RD was 9.27±0.980 min and in Group R was 16.00±1.438 min (p <0. 001) Onset of motor block in Group RD was 14.07±1.929 min and in Group R was 20.27±1.799min (P = 0.2244). Conclusion: Dexamethasone, when added as an adjuvant to ropivacaine during ISBP block, significantly prolonged duration of analgesia and shortened the onset of sensory and motor block. It provided prolonged post-operative pain relief and hence reduced the number of rescue analgesics required in first 24 hours.
Authors and Affiliations
Deeksha Bindal, Varun Kumar Saini, Gaurav Sharma
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