PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
Synapse
⌘+K
Synapse
July 10, 2023CureusOpen Access

The Comparison of Dexmedetomidine to Dexamethasone as Adjuvants to Bupivacaine in Ultrasound-Guided Infraclavicular Brachial Plexus Block in Upper Limb Surgeries

View Full Paper
Ask AI
Bookmark
Share

Why the study?

The objective was to compare the effectiveness of dexamethasone versus dexmedetomidine as adjuvants to bupivacaine in patients undergoing ultrasound-guided infraclavicular brachial plexus block.

Does dexmedetomidine compared to dexamethasone improve the onset and duration of sensory and motor blocks when used as an adjuvant to bupivacaine in patients undergoing upper limb surgeries?

Population

Sixty ASA class I and II patients posted for upper limb surgeries

Comparison

Bupivacaine plus dexamethasone vs bupivacaine plus dexmedetomidine

Design

Randomized prospective double-blind study

Key result

Dexamethasone (6 mg) added to bupivacaine significantly prolonged the duration of sensory block (1091.79 vs 734 minutes) and motor block compared to dexmedetomidine (75 mcg) in patients undergoing upper limb surgeries.

Authors

SISwathy S IyengarAPAnshu PangotraAKAbhishek Kumar

Discussion

Loading...

Member takes

Overview

Dexamethasone is a superior adjuvant to bupivacaine for infraclavicular brachial plexus blocks compared to dexmedetomidine, providing longer block duration and analgesia with less sedation.

Study Design

Type

RCT (n=60)

Blinding

Double-blind

Randomization

Computer-generated randomization numbers and sealed envelope method

Multicenter

No

Structured PICO

Does dexmedetomidine compared to dexamethasone improve the onset and duration of sensory and motor blocks when used as an adjuvant to bupivacaine in patients undergoing upper limb surgeries?

P
Population
60 ASA grade I and II adults aged 18-60 years undergoing elective upper limb surgery under ultrasound-guided infraclavicular brachial plexus block, followed for 24 hours.
I
Intervention
Dexmedetomidine 75 mcg (0.75 mL) and 0.75 mL of 0.9% normal saline added to 25 mL of 0.5% bupivacaine.
C
Comparator
Dexamethasone 6 mg (1.5 mL) added to 25 mL of 0.5% bupivacaine.
O
Outcome
Onset and duration of sensory and motor blocks.surrogate

Main Result

Absolute Event Rate: 1091.79% vs 734%

p-value: p=<0.0001

Dexamethasone is a superior adjuvant to bupivacaine for infraclavicular brachial plexus blocks compared to dexmedetomidine, providing longer block duration and analgesia with less sedation.

Limitations

  • Fixed doses of drugs instead of doses adjusted to body weight
  • Relatively small sample size
  • Observation period limited to 24 hours after surgery
  • Wide variety of procedures performed by various surgeons
  • Fixed doses of drugs used instead of weight-adjusted doses
  • Included a wide variety of procedures performed by various surgeons

Cite This Study

Iyengar et al. (2023) conducted an RCT in Elective upper limb surgery (n=60). Dexamethasone vs. Dexmedetomidine (75 mcg) was evaluated on Duration of sensory block (minutes) (p=<0.0001). Dexamethasone (6 mg) added to bupivacaine significantly prolonged the duration of sensory block (1091.79 vs 734 minutes) and motor block compared to dexmedetomidine (75 mcg) in patients undergoing upper limb surgeries.

synapsesocial.com/papers/6a7eedff1e6c106288f008b8https://doi.org/10.7759/cureus.41668
View Full Paper
Ask AI
Bookmark
Share