A comparative study of anesthetic properties of bupivacaine alone and in combination with dexamethasone for supraclavicular brachial plexus block in patients undergoing elective upper limb surgeries
Abstract
Bupivacaine is one of the local anesthetic used most frequently as it has a longer duration of anesthesia. Sometime other medicines are used to get better effect. So this study was conducted to compare the anesthetic effect of Bupivacaine alone and Bupivicaine along with Dexamethasone. For this purpose 30 upper limb surgery cases were given Bupivacaine alone and 30 upper limb surgery cases were given Bupivicaine along with Dexamethasone. The mean time of onset of sensory block in Bupivacaine group was 16.7 minutes and 10.3 minutes in Bupivacaine plus Dexamethasone group. The mean time of onset of motor block with Bupivacaine group was 8.6 (± 1.2) minutes and with Bupivacaine plus Dexamethasone group was 5.6 (± 0.7) minutes. The mean duration of sensory block in Bupivacaine group was 4 (± 6.3) hours and in Bupivacine plus Dexamethasone group was 5.9 (± 0.7) hours. The mean duration of motor block in Bupivacaine group was 1.9 (± 0.5) hours and in Bupivacaine plus Dexamethasone group was 4.3 (± 0.9) hours. It can be concluded from this study that time taken to onset of sensory block and motor block was significantly earlier in Bupivacaine plus Dexamethasone group than Bupivicaine only group. Although there was no significant difference in duration of sensory block in both the group but duration of motor block was significantly more in Bupivacaine plus Dexamethasone group than Bupivicaine only group. Number of rescue analgesic doses in 24 hours required were significantly more in Bupivacaine than Bupivacaine plus Dexamethasone groups.
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Introduction
Brachial plexus block is a popular approach for upper limb surgeries as an alternative to general anesthesia. This type of anesthesia mainly helps in to achieve ideal operating conditions by producing muscular relaxation, maintaining stable intra- operative hemodynamic condition and sympathetic block which reduces postoperative pain, vasospasm and edema.1
A variety of approaches of brachial plexus block have been described in the literature. However supraclavicular block is a consistent and easiest method for anesthesia and post operative pain Management.3,4,5
Bupivacaine one is of the local anesthetic used most frequently as it has a longer duration of action varying from 3 to 8 hours. However, it has limiting factors like delayed onset, patchy or incomplete analgesia.
Conclusion
It can be concluded from this study that time taken to onset of sensory block and motor block was significantly earlier in Bupivacaine plus Dexamethasone group than Bupivicaine only group. Although there was no significant difference in duration of motor block in both the group but duration of motor block was significantly more in Bupivacaine plus Dexamethasone group than Bupivicaine only group. Number of rescue analgesic doses in 24 hours were required significantly more in Bupivacaine than Bupivacaine plus Dexamethasone groups.