Key result
Dexamethasone as an adjuvant to levobupivacaine significantly accelerated the onset of sensory block to 3.86 minutes compared to 5.41 minutes with tramadol.
Why the study?
The study was conducted to evaluate and compare dexamethasone and tramadol as adjuvants to levobupivacaine in supraclavicular block.
Does dexamethasone compared to tramadol improve block characteristics and analgesia when added to levobupivacaine in supraclavicular block in patients undergoing forearm or hand surgery?
RCT (n=50)
No
Does dexamethasone compared to tramadol improve block characteristics and analgesia when added to levobupivacaine in supraclavicular block in patients undergoing forearm or hand surgery?
Absolute Event Rate: 3.86% vs 5.41%
p-value: p=0.01
Dexamethasone is a superior adjuvant to tramadol when added to levobupivacaine for supraclavicular brachial plexus block, providing faster onset and longer duration of analgesia.
May support dexamethasone over tramadol for faster sensory onset in supraclavicular blocks; leaves open confirmation in randomized trials.
Background: The present study was conducted to evaluate and compare dexamethasone and tramadol as adjuvant to levobupivacaine in supraclavicular block. Subjects and Methods: The present study was conducted on 50 patients of American Society of Anesthesiologists (ASA) grade I and II. Patients were divided in to two groups of 25 each. In group I, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml tramadol (100 mg) was used. In group II, 30 ml of 0.5% levobupivacaine hydrochloride plus 2 ml dexamethasone (8 mg) was used. Visual Analogue Scale was used. The onset of sensory and motor block was evaluated.Results: The mean onset of sensory block in group I was 5.41 minutes and in group II was 3.86 minutes, motor onset was 9.12 minutes in group I and 7.25 minutes in group II, duration of sensory block in group I was 12.14 hours and in group II was 15.34 hours, duration of motor block in group I was 14.34 hours and I group II was 16.23 hours, duration of analgesia in group I was 16.1 hour and in group II was 18.4 hours. The difference was significant difference (P<0.05). The mean VAS score in group II was better as compared to group I (P <0.05). Conclusion:Authors found that dexamethasone is a better adjuvant than tramadol when added to levobupivacaine in supraclavicular brachial plexus block.
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Pandey et al. (2020) conducted an RCT in Surgery of the forearm or hand (n=50). Dexamethasone vs. Tramadol 100 mg (added to 30 ml of 0.5% levobupivacaine) was evaluated on Onset of sensory block (p=0.01). Dexamethasone as an adjuvant to levobupivacaine significantly accelerated the onset of sensory block to 3.86 minutes compared to 5.41 minutes with tramadol.
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