Comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries
Background: Brachial plexus block (BPB) is widely used nowadays in patients undergoing upper limb surgery. Levobupivacaine is one of the best local anesthetics in the current scenario in this field. Both dexmedetomidine (DM) and dexamethasone (DX) are commonly used local anesthetic adjuvants in BPB...
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| Format: | Article |
| Language: | English |
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Manipal College of Medical Sciences, Pokhara
2023-12-01
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| Series: | Asian Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/56262 |
| _version_ | 1827620076438683648 |
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| author | Suman Sarkar Debarati Goswami Sujan Sarkar Sandesh Rathod |
| author_facet | Suman Sarkar Debarati Goswami Sujan Sarkar Sandesh Rathod |
| author_sort | Suman Sarkar |
| collection | DOAJ |
| description | Background: Brachial plexus block (BPB) is widely used nowadays in patients undergoing upper limb surgery. Levobupivacaine is one of the best local anesthetics in the current scenario in this field. Both dexmedetomidine (DM) and dexamethasone (DX) are commonly used local anesthetic adjuvants in BPB to enhance blocking effects. In anesthesiology, there is always a search for a better alternative.
Aims and Objectives: In this study, we investigated the effect of DM and DX as adjuvants to levobupivacaine on the quality of supraclavicular BPB.
Materials and Methods: A prospective, double-blind, randomized controlled intervention study (superiority trial) was done involving 60 patients aged 20–60 years, randomly allocated into two equal groups (group S-DM group-Patients were received Injection 0.25% Levobupivacaine 2 mg/kg body weight+Inj. DM 1 mcg/kg body weight+distilled water [total volume 30 mL] and group C-DX group-Patients received Inj. 0.25% Levobupivacaine 2 mg/kg+Inj. DX 0.1 mg/kg body weight+Distilled water [total volume 30 mL]). The scores of the modified Gormley and Hill scale and the modified Bromage scale were recorded along with hemodynamic parameters. Pearson’s Chi-square test, Mann-Whitney U-test, one-way ANOVA, Kaplan–Meier survival analysis, and Z-test were used for statistical analysis.
Results: The onset of motor block was shorter in group-S patients (14.2667±1.0807 [min]) compared to group-C (15.9333±1.5742 [min]), and the duration of motor block was higher in group-S (708.5667±4.2644 [min]) compared to group-C patients (682.3667±20.0095 [min]) (P<0.001).
Conclusion: DM is a better alternative to DX when added to levobupivacaine for decreasing the onset of sensory and motor block and increasing the duration of supraclavicular BPB. |
| first_indexed | 2024-03-09T10:42:33Z |
| format | Article |
| id | doaj.art-630726b3100d48c2a3ec1c7f4f17a00d |
| institution | Directory Open Access Journal |
| issn | 2467-9100 2091-0576 |
| language | English |
| last_indexed | 2024-03-09T10:42:33Z |
| publishDate | 2023-12-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj.art-630726b3100d48c2a3ec1c7f4f17a00d2023-12-01T13:10:41ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762023-12-0114121620https://doi.org/10.3126/ajms.v14i12.56262Comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeriesSuman Sarkar 0Debarati Goswami 1https://orcid.org/0000-0002-6882-5338Sujan Sarkar 2Sandesh Rathod 3https://orcid.org/0009-0007-3804-821XAssociate Professor, Department of Anaesthesiology, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, IndiaAssistant Professor, Department of Anaesthesiology, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India Medical Officer (Specialist), Department of Anaesthesiology, Birpara S.G. Hospital, Alipurduar, West Bengal, IndiaPostgraduate Trainee, Department of Anaesthesiology, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal, India Background: Brachial plexus block (BPB) is widely used nowadays in patients undergoing upper limb surgery. Levobupivacaine is one of the best local anesthetics in the current scenario in this field. Both dexmedetomidine (DM) and dexamethasone (DX) are commonly used local anesthetic adjuvants in BPB to enhance blocking effects. In anesthesiology, there is always a search for a better alternative. Aims and Objectives: In this study, we investigated the effect of DM and DX as adjuvants to levobupivacaine on the quality of supraclavicular BPB. Materials and Methods: A prospective, double-blind, randomized controlled intervention study (superiority trial) was done involving 60 patients aged 20–60 years, randomly allocated into two equal groups (group S-DM group-Patients were received Injection 0.25% Levobupivacaine 2 mg/kg body weight+Inj. DM 1 mcg/kg body weight+distilled water [total volume 30 mL] and group C-DX group-Patients received Inj. 0.25% Levobupivacaine 2 mg/kg+Inj. DX 0.1 mg/kg body weight+Distilled water [total volume 30 mL]). The scores of the modified Gormley and Hill scale and the modified Bromage scale were recorded along with hemodynamic parameters. Pearson’s Chi-square test, Mann-Whitney U-test, one-way ANOVA, Kaplan–Meier survival analysis, and Z-test were used for statistical analysis. Results: The onset of motor block was shorter in group-S patients (14.2667±1.0807 [min]) compared to group-C (15.9333±1.5742 [min]), and the duration of motor block was higher in group-S (708.5667±4.2644 [min]) compared to group-C patients (682.3667±20.0095 [min]) (P<0.001). Conclusion: DM is a better alternative to DX when added to levobupivacaine for decreasing the onset of sensory and motor block and increasing the duration of supraclavicular BPB.https://www.nepjol.info/index.php/AJMS/article/view/56262levobupivacaine; dexmedetomidine; dexamethasone; supraclavicular brachial plexus block; peripheral nerve stimulator |
| spellingShingle | Suman Sarkar Debarati Goswami Sujan Sarkar Sandesh Rathod Comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries Asian Journal of Medical Sciences levobupivacaine; dexmedetomidine; dexamethasone; supraclavicular brachial plexus block; peripheral nerve stimulator |
| title | Comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries |
| title_full | Comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries |
| title_fullStr | Comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries |
| title_full_unstemmed | Comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries |
| title_short | Comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries |
| title_sort | comparative study between dexmedetomidine and dexamethasone as an adjuvant to levobupivacaine for supraclavicular brachial plexus block in patients undergoing upper limb surgeries |
| topic | levobupivacaine; dexmedetomidine; dexamethasone; supraclavicular brachial plexus block; peripheral nerve stimulator |
| url | https://www.nepjol.info/index.php/AJMS/article/view/56262 |
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