Regional, Intravenous, Dexamethasone, Prophylaxis, Rebound Pain, Supraclavicular Block, Upper Limb Surgeries
Conditions
Brief summary
This study aimed to compare the effect of regional and intravenous Dexamethasone in the prophylaxis of rebound pain after supraclavicular block in upper limb surgeries.
Detailed description
Rebound pain is defined as a transient acute increase in postoperative pain which occurs following resolution of a peripheral nerve block (PNB) or as a phenomenon where a quantifiable difference is seen in the pain scores when the PNB is working compared to when its effect is resolved. The supraclavicular block is a regional anesthetic technique used as an alternative or adjunct to general anesthesia or used for postoperative pain control for upper extremity surgeries (mid-humerus through the hand). Dexamethasone, an adjunct used to prolong the duration of neural blockade when administered regionally or systemically, is thought to reduce pain sensitization by inhibiting sensory transmission of nociceptive C-fibers at the dorsal root ganglion and reducing prostaglandin synthesis, thereby suppressing hyperalgesia.
Interventions
DRUGRegional Dexamethasone
Patients were generally anesthetized, then a supraclavicular block is given (0.5% bupivacaine + dexamethasone 8 mg regionally), total volume = 20 mL (18 mL 0.5% bupivacaine + 2 mL dexamethasone).
Patients were generally anesthetized, and then a supraclavicular block was administered (0.5% bupivacaine), with a total volume of 20 mL (18 mL of 0.5% bupivacaine and 2 mL of normal saline).
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
21 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age from 21 to 65 years. * Both sexes. * American Society of Anesthesiology (ASA) class I-II. * Undergoing upper limb surgeries.
Exclusion criteria
* Patient refusal. * History of allergy to drugs used. * ASA class more than II ( III-IV-..). * Uncooperative patient. * Patients on chronic pain medications. * Coagulopathy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to the first request of analgesia | 24 hours postoperatively | Time to the first request of analgesia was recorded from the end of surgery till the first dose of pethidine administrated. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Degree of pain | 24 hours postoperatively | All patients were familiarized with the Numeric Rating Scale (NRS) from 0 to 10, with 0 representing no pain and 10 representing maximum intolerable pain. NRS score will be assessed and recorded at 30 minutes, 2, 6, 12, 18, 24 hours postoperatively. |
| Patient Satisfaction | 24 hours postoperatively | Postoperative Patient Satisfaction measured in 4 scale patient satisfaction score ( 1 = highly satisfied , 2 = fairly satisfied , 3 = little satisfied , 4 = non satisfied ). |
| Total Analgesics consumption | 24 hours postoperatively | Pethidine 50 mg intravenous was given as postoperative rescue analgesia when the Numeric Rating Scale (NRS) score was≥ 4. |
| Incidence of complications | 24 hours postoperatively | Incidence of complications such as nausea, vomiting, hypotension and bradycardia were recorded. |
Countries
Egypt
Outcome results
None listed