Key result
Dexamethasone added to bupivacaine prolongs postoperative analgesia by ~125% vs tramadol in upper extremity surgery.
Why the study?
The comparative efficacy of tramadol versus dexamethasone as adjuvants to bupivacaine in supraclavicular brachial plexus block for postoperative analgesia in upper limb surgery was unclear.
Does dexamethasone compared to tramadol prolong postoperative analgesia when added to bupivacaine in patients undergoing elective upper limb surgeries?
RCT (n=60)
Double-blind
Chit and box method
No
Does dexamethasone compared to tramadol prolong postoperative analgesia when added to bupivacaine in patients undergoing elective upper limb surgeries?
Absolute Event Rate: 1023.87% vs 454.47%
p-value: p=<0.05
Dexamethasone as an adjuvant to bupivacaine significantly prolongs postoperative analgesia compared to tramadol in patients undergoing upper limb surgeries under supraclavicular brachial plexus block.
Supports preferring dexamethasone over tramadol as bupivacaine adjuvant in upper extremity surgery; extends RCT evidence on brachial plexus block adjuvants.
Background: Supraclavicular nerve block is a good alternative to general anesthesia for upper limb surgery.This avoids the untoward effects of general anesthetic drugs and upper airway instrumentation.It achieves complete muscle relaxation, intraoperative hemodynamic stability, and postoperative analgesia.Objectives: To compare the postoperative analgesia following supraclavicular brachial plexus block with Tramadol or Dexamethasone as an adjuvant to bupivacaine in elective upper extremity surgery.Materials and Methods: Total 60 patients of ASA I and II undergoing upper extremity surgery under brachial plexus block with Bupivacaine were randomly divided in to two groups; group A received Tramadol (2mg/kg) and group B received Dexamethasone (0.15mg/kg) as an adjuvant to Bupivacaine.The duration of postoperative analgesia was recorded in both groups using pain VAS score which was determined by maximum VAS score of 8-10 and when patient demands for additional analgesia.Results: The mean duration of postoperative analgesia in the Dexamethasone group was 1023.87 -+161.01minutes while in the tramadol group it was 454.47+-44.29 minutes.Conclusion: Dexamethasone with local anaesthetic prolongs postoperative analgesia significantly longer than Tramadol (P<0.05) when used as admixture to local anaesthetic in brachial plexus block in upper extremity surgery.
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Shah et al. (2016) conducted an RCT in Elective upper extremity surgery (n=60). Dexamethasone vs. Tramadol 2 mg/kg added to 0.5% Bupivacaine 2 mg/kg was evaluated on Duration of postoperative analgesia (p=<0.05). Dexamethasone as an adjuvant to bupivacaine significantly prolonged the mean duration of postoperative analgesia compared to tramadol (1023.87 vs 454.47 minutes) in patients undergoing upper extremity surgery.
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