Key result
Dexamethasone added to bupivacaine speeds brachial plexus block onset and prolongs analgesia versus ketamine.
Why the study?
The comparative effects of ketamine versus dexamethasone added to bupivacaine in ultrasound guided infraclavicular brachial plexus block for upper limb surgeries were not well established.
Does dexamethasone compared to ketamine improve block characteristics and postoperative analgesia when added to bupivacaine for ultrasound guided infraclavicular brachial plexus block in upper limb surgeries?
RCT (n=50)
Randomized
Does dexamethasone compared to ketamine improve block characteristics and postoperative analgesia when added to bupivacaine for ultrasound guided infraclavicular brachial plexus block in upper limb surgeries?
The addition of dexamethasone to bupivacaine for infraclavicular brachial plexus block provides faster onset and longer duration of analgesia compared to ketamine.
Supports dexamethasone over ketamine as bupivacaine adjunct for infraclavicular block; extends RCT evidence on perineural adjuvants in upper limb surgery.
the aim of this study is to compare between ketamine and dexamethasone when added to bupivacaine in ultrasound guided infraclavicular brachial plexus block for upper limb surgeries. Methods: The patients were randomly allocated to two groups, 25 patients each: Group K (ketamine group) Patient received 30 ml of 0.375% bupivacaine plus 0.5 mg/kg ketamine in 2 ml saline Group D (dexamethasone group) Patient received 30 ml of 0.375 bupivacaine plus 8 mg dexamethasone in 2 ml. Results: Onset time of sensory and motor blocks was significantly decreased in dexamethasone group in comparison with the ketamine group. The visual analogue scale was significantly lower in patients who received dexamethasone versus patients who received local anesthetics and ketamine. The duration of analgesia and resolution of motor block were significantly prolonged in dexamethasone group as compared to ketamine group. Postoperative analgesic consumption was reduced significantly in dexamethasone group as compared with ketamine group. Conclusion: The addition of dexamethasone to bupivacaine resulted in significant reduction in onset time of sensory and motor blocks, prolonged duration of post-operative analgesia, lower analgesic consumption and lower incidence of complications.
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Bakheet et al. (2017) conducted an RCT in Upper limb surgeries requiring brachial plexus block (n=50). Dexamethasone added to bupivacaine vs. Ketamine added to bupivacaine (30 ml of 0.375% bupivacaine plus 0.5 mg/kg ketamine in 2 ml saline) was evaluated on Onset time of sensory and motor blocks. Dexamethasone added to bupivacaine significantly reduced sensory and motor block onset time and prolonged postoperative analgesia compared to ketamine in infraclavicular brachial plexus block.
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