Anesthesia
Conditions
Brief summary
Brachial plexus block is a very reliable method of regional anesthesia for the upper limb. It achieves ideal operating conditions by producing complete muscular relaxation and stable intraoperative hemodynamics.However,Local anesthetics alone have a shorter duration of postoperative analgesia. Hence,various adjuvants have been added to local anesthetics to achieve quick, dense, and prolonged block. This study assess and compare the efficacy of dexamethasone or nalbuphine as adjuvants to local anesthetics in supraclavicular brachial plexus block for upper limb surgeries.
Detailed description
Upper-limb surgeries can be performed under either general or regional anesthesia.However, regional anesthesia has the advantages of long-lasting pain relief & avoidance of airway instrumentation.Brachial plexus block is a very reliable method of regional anesthesia for the upper limb. It achieves ideal operating conditions by producing complete muscular relaxation and stable intraoperative hemodynamics.However,Local anesthetics alone have a shorter duration of postoperative analgesia. Hence,various adjuvants have been added to local anesthetics to achieve quick, dense, and prolonged block. This study assess and compare the efficacy of using 8 mg dexamethasone or 10 mg nalbuphine as adjuvants to local anesthetics mixture (Lidocaine 2% + bupivacaine 0.5% 1:1 mixture) in Ultrasound-guided supraclavicular brachial plexus block for upper limb surgeries below the level of the shoulder.
Interventions
PROCEDUREUltrasound (US) guided supraclavicular brachial plexus block
Using 8 mg dexamethasone or 10 mg nalbuphine as adjuvants to (Lidocaine 2% + bupivacaine 0.5% 1:1 mixture) in ultrasound (US) guided supraclavicular brachial plexus block
Sponsors
Zagazig University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patient acceptance. * American Society of Anesthesiologists (ASA) I and (ASA) II. * Age 21-60 years old. * Both gender. * BMI \< 30. * Accepted mental state of the patient. * Unilateral upper limb surgeries below the level of the shoulder.
Exclusion criteria
* Patient refusal. * Peripheral neuropathy. * Pathological coagulopathy. * Infection at the injection site. * History of active substance abuse. * Untreated pneumothorax. * Disturbed conscious level. * An allergy to local anesthetics or nalbuphine or dexamethasone. * Planned for receiving general anesthesia during the same operation for any cause.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Duration of postoperative analgesia | First 24 hours after surgery | Time between onset of sensory block to the first report of postoperative pain at the surgical site that has a VAS visual analogue score ≥ 4. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| post operative pain score Visual Analogue Score | First 24 hours after surgery | On a scale of 0-10, the patient will be asked to quantify postoperative pain as the following: 0: No pain 10: Maximum/worst imaginable pain. Visual Analog Scale assessment will be done every 5 minutes for first 30 minutes, then hourly for first 8 hours then every 4 hourly till patient complained of pain equivalent to a VAS score of 4. Rescue analgesia (injection of fentanyl 25 mcg intravenous increments) up to 200 μg/hour is administered when VAS score reached 4. |
| The total opioid consumption | First 24 hours after surgery | Total dose of fentanyl as a rescue analgesic in the first 24 hours |
Countries
Egypt
Outcome results
None listed