COMPARISON BETWEEN 0.5% BUPIVACAINE-DEXAMETHASONE COMBINATION & 0.5% BUPIVACAINE - CLONIDINE COMBINATION IN BRACHIAL PLEXUS BLOCKS BY SUPRACLAVICULAR APPROACH
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2015, Vol 2, Issue 20
Abstract
BACKGROUND: Brachial plexus blocks, alone or in combination with general anesthesia, has become one of the most important anesthesia techniques for surgeries in the upper limb. Prolongation of analgesia using perineural catheters are not yet popular, and we are in need for an adjuvant that can prolong the action of local anesthetics after single injection peripheral nerve blocks. Dexamethasone and clonidine are two commonly used adjuvants. This study was undertaken to compare the analgesic efficacy of dexamethasone and clonidine. MATERIALS AND METHODS: Ninety adult patients fitting under the inclusion criteria were assigned to three groups of thirty each and received ultrasound guided supraclavicular brachial plexus block. They received either dexamethasone 8 mg (Group D) or clonidine 1mcg/kg (Group C) or saline 2 ml (Group S) with 15 ml of 0.5% bupivacaine. The onset of sensory and motor blocks, duration of analgesia and the duration of motor block were assessed. RESULTS: The onset of sensory and motor block were comparable in all the three groups (17.50±2.86 minutes and 30.33±4.14 minutes; 17.17±3.13 minutes and 31.0±4.8 minutes; 18.33±3.55 minutes and 31.0±5.48 minutes for groups D, C and S respectively. The duration of analgesia and motor blockade was markedly prolonged in dexamethasone group (19.41±2.60 hours and 17.19±2.13 hours) and moderately prolonged clonidine group (11.49±1.66 hours and 10.41±1.18 hours) when compared to saline group (7.56±1.65 hours and 6.22±1.43 hours). CONCLUSION: Dexamethasone proves to be a better adjuvant compared to clonidine, as it considerably prolongs analgesia and is devoid of significant side effects. But the prolonged motor block is still a matter of concern and the search for an adjuvant that selectively prolongs analgesia without impairing motor function continues.
Authors and Affiliations
Hari Kishore, Rajagopal P, Binu Puthur Simon, Karthika Asokan
Keywords
Related Articles
- EP ID EP228849
- DOI 10.18410/jebmh/2015/437
- Views 114
- Downloads 0
A CROSS SECTIONAL STUDY OF PREVALENCE AND TYPE OF DIABETIC FOOT ULCERS IN TYPE 2 DIABETIC MELLITUS PATIENTS
BACKGROUND: Diabetic foot ulcers are common and estimated to affect 15% of all diabetics. In India it is estimated that approximately 40,000 legs are being amputated every year of which 75% are potentially preventable. M...
EVALUATION OF ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING QUADRUPLE HAMSTRING TENDON GRAFT
BACKGROUND The anterior cruciate ligament (ACL) tear is the most common ligamentous injury to the knee joint. To reconstruct the tear in ACL the grafts and the fixation techniques used to vary with different surgeons. Th...
A CASE REPORT ON ZINC PHOSPHIDE POISONING AND ITS RARE EFFECTS
BACKGROUND Zinc phosphide is widely in use as a rodenticide. After ingestion, it gets converted to phosphine gas, which is subsequently absorbed into the bloodstream through the stomach and the intestines and gets captur...
RECURRENCE IN GRANULOSA CELL TUMOUR OF THE OVARY- A RETROSPECTIVE STUDY
BACKGROUND 5% of all ovarian cancers are granulosa cell tumour. However, they are the most common subtype of ovarian sex-cord tumours (70%). They usually occur in young women and are usually detected at an early stage. T...
AN AUTOPSY STUDY ON PATTERN OF FATAL INJURIES SUSTAINED BY PEDESTRIANS
Road traffic accidents are among the most common cause of death in India. According To WHO statistics it is the 9th leading cause of death in 2004 and projected to be the 5 th leading cause by 2030. 1 Among road traffic...