Key result
The addition of 8mg dexamethasone to 0.5% levobupivacaine significantly prolonged the time to first rescue analgesia compared to levobupivacaine alone (749.38 vs 431.50 minutes, p<0.001).
Why the study?
The study evaluated the analgesic and anesthetic effects of adding dexamethasone to levobupivacaine for ultrasonography-assisted supraclavicular brachial plexus block in patients listed for upper limb surgeries.
Does the addition of dexamethasone to levobupivacaine prolong the time to first rescue analgesia in adult patients undergoing upper limb surgeries with supraclavicular brachial plexus block?
RCT (n=60)
Double-blind
Sealed enveloped method
No
Does the addition of dexamethasone to levobupivacaine prolong the time to first rescue analgesia in adult patients undergoing upper limb surgeries with supraclavicular brachial plexus block?
Absolute Event Rate: 749.38% vs 431.5%
p-value: p=<0.001
The addition of 8mg dexamethasone to 0.5% levobupivacaine in supraclavicular brachial plexus block significantly prolongs the time to first rescue analgesia and reduces the need for rescue analgesics.
Supports adding 8 mg dexamethasone to levobupivacaine for extended analgesia after upper limb surgery; extends RCT evidence on perineural adjuvants in brachial plexus blocks.
Background: Ultrasonography-assisted supraclavicular block is an efficacious and practical method and allows us to use a lower volume of local anesthetic in compactly arranged brachial plexus. The study envisioned evaluating the analgesic and anesthetic effects of Inj. dexamethasone (8mg) as an adjuvant to 0.5% levobupivacaine to determine the time for first rescue analgesia and number of rescue analgesics needed in 24 hours duration in brachial plexus blockade in adult patients listed for upper limb surgeries. Results: This prospective randomized double-blind interventional study was carried out in ASAI and II, aged 20 to 55 years. In group A (n=30) Inj. Levobupivacaine 20ml and Inj. Normal saline 2ml was given. In group B (n=30) Inj. Levobupivacaine 20ml and Inj. Dexamethasone 2ml was given. The time for the demand of the first rescue analgesia was 431.50 ± 46.15 minutes in group A and 749.38 ± 62.41 minutes in group B, with a p-value < 0.001. The demand for rescue analgesics was more in Group A in contrast to Group B. Conclusion: We deduce with our study, with the addition of dexamethasone, the time for rescue analgesia is prolonged, and the number of rescue analgesic demands is reduced, with a faster onset and extended duration of both sensory and motor block.
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Das et al. (2022) conducted an RCT in Upper limb surgeries (n=60). Levobupivacaine with Dexamethasone vs. 20ml 0.5% levobupivacaine with 2mL normal saline was evaluated on Time for first rescue analgesia (minutes) (p=<0.001). The addition of 8mg dexamethasone to 0.5% levobupivacaine significantly prolonged the time to first rescue analgesia compared to levobupivacaine alone (749.38 vs 431.50 minutes, p<0.001).
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