Effect of magnesium sulphate on quality of subarachnoid block in terms of onset and duration of motor and sensory block, APGAR score of the neonate and haemodynamic status of the patient

Background In obstetrics, pregnancy induced hypertension is still a burning question and complicates a large number of pregnancies in developing countries. Chance of hypotension is more in patients getting magnesium sulfate with subarachnoid block but it may be managed with adequate preloading and by pressor agent ephedrine. Objectives This study was designed to observe the effect of magnesium sulphate on quality of subarachnoid block in terms of onset and duration of motor and sensory block, APGAR score of the neonates and haemodynamic status of the patients. Methods Sixty parturients undergoing caesarian sections under subarachnoid block were enrolled for the study. They were divided into two groups. Group-A include normal parturient undergoing caesarian section and group-B include pre-celamptic parturient treated with magnesium sulphate within 1 to 2 hours before block. After recording of base line haemodynamic status (BP, HR, SPO2) all patients received subarachnoid block with 2 ml (10 mg) hyperbaric bupivacaine at L3-4 level. Onset of sensory block was assessed by using pinprick, onset of motor block was assessed by onset time of weakness of lower limb and onset time of complete paralysis of lower limb after SAB. Duration of motor block was assessed by modified bromage scale. Height of the block was assessed by using pin prick at the intercostals space in the mid axillary line after 5 minute of SAB. Neonatal assessment was done by using apgar score in 1 and 5 minutes after delivary of baby. Blood pressure was recorded normally at 2 min interval until 15 minutes then every 5 minutes interval till the surgical procedure is completed. Results Duration of motor block in group B is significantly higher 276 ± 44.92 min compared with group A which was 197.96 ± 24.25 min (P = 0.000). Duration of sensory block in group B also significantly higher with 308.76 ± 61.43 min compared with group A which was 264 ± 30.57 min, and (P = 0.001). Changes in systolic blood pressure in group B patient is more and highly significant (P < .05), for upto 60 min. But changes in diastolic blood pressure in-group B was only highly significant with group A for upto 9 minutes. APGAR score was significantly low both in 1 minute and 5 minutes, in group B patients which was 5.80 ± .61 at 1 minute and 7.73 ± .827 at 5 minutes and in group A which was 6.60 ± .85 at 1 minute and 8.30 ± .595 (mean ± SD) at 5 minutes. Onset of sensory block and onset of motor block revealed on significant difference between groups. Conclusions Chance of hypotension is more in patients getting magnesium sulfate but it may be managed with adequate preloading and by pressor agent ephedrine. APGAR score of baby of magnesium sulfate getting patient is low but it is acceptable. DOI: http://dx.doi.org/10.3329/jbsa.v24i2.19800 Journal of Bangladesh Society of Anaesthesiologists 2011; 24(2): 41-47

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Comparison of two different doses dexmedetomidine as an adjuvant to bupivacaine in sub-arachnoid block for abdominal hysterectomies. A randomized double blinded study.

Asian Journal of Medical Sciences ◽

10.3126/ajms.v8i2.16163 ◽

2017 ◽

Vol 8 (2) ◽

pp. 59-63

Author(s):

R Krishna Prabhu ◽

A Radhakrishnan

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Pain Relief ◽

Blood Loss ◽

Motor Block ◽

Sensory Block ◽

Abdominal Hysterectomy ◽

Group A ◽

Group B ◽

Different Doses

Background: Abdominal hysterectomy is often a long duration procedure and warrants intense pain relief in the post-operative period. Dexmedetomidine when added to bupivacaine in subarachnoid block prolongs the duration of surgical anaesthesia, decreases blood loss and prolongs duration of post-operative pain relief. Aims and Objective: To compare two different doses dexmedetomidine as an adjuvant to bupivacaine in sub-arachnoid block in abdominal hysterectomy surgeries. Materials and Methods: 60 patients of age group 30-60 years posted for elective abdominal hysterectomies under American Society of Anaesthesiologists (ASA) physical classification I or II were randomly allocated into 2 groups of 30 each. Group A received 5 micrograms (μg) of dexmedetomidine along with 3.5 ml of 0.5% bupivacaine in sub-arachnoid block. Group B received 10 μg of dexmedetomidine along with 3.5 ml of 0.5% bupivacaine in sub-arachnoid block. Changes in blood pressure, heart rate, respiratory rate, oxygen saturation, ephedrine consumption, blood loss, duration of sensory block, duration of motor block, duration of analgesia were compared between two groups. Results: There was no significant difference in change in heart rate, respiratory rate, oxygen saturation, duration of sensory block, duration of motor block between two groups. Patients in group B had significant decrease in blood pressure, blood loss and significant increase in ephedrine consumption compared to Group A. The duration of analgesia was also prolonged in group B compared to Group A. Conclusion: Dexmedetomidine in dose of 10 μg is a better adjuvant to bupivacaine for abdominal hysterectomy surgeries.Asian Journal of Medical Sciences Vol.8(2) 2017 59-63

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COMPARISON BETWEEN PERINEURAL DEXAMETHASONE AND INTRAVENOUS MAGNESIUM SULPHATE AS ADJUVANT IN SUPRACLAVICULAR BLOCK

QJM ◽

10.1093/qjmed/hcab086.081 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Ahmed Nagah El-Shaer ◽

Ahmed Kamal Mohamed Ali ◽

Farouk Kamal Eldeen Abd El-Aziz ◽

Mostafa Samir El-Sayed

Keyword(s):

Upper Extremity ◽

Magnesium Sulphate ◽

Regional Anaesthesia ◽

Motor Block ◽

Sensory Block ◽

University Hospital ◽

Study Patient ◽

Rescue Analgesia ◽

Group A ◽

Group B

Abstract Background: Upper extremity surgeries are commonly performed under regional anaesthesia. Regional anaesthesia of the upper extremity has several advantages over general anaesthesia such as improved postoperative pain management, decreased postoperative narcotic consumption, and reduced recovery time. Objectives: The aim of the study was to compare between dexamethasone and magnesium sulphate as adjuvants in supraclavicular brachial plexus block as regards the onset and duration of sensory and motor block as well as side effects. Patients and Methods: This prospective double-blinded comparative study was carried out in Faculty of Medicine, Ain-Shams University Hospital on 120 adult patients between 21-50 years of both sexes with ASA classification 1&2 who were scheduled for elective upper limb orthopaedic surgeries. A written informed consent was obtained from all patients. Every patient received an explanation about the purpose of the study. Procedures had been approved by the institutional and the regional ethical committee. Total 120 patients are enrolled in the study and divided into 3 groups A and B and C (40 for each one). Results From aspect of increasing the duration of sensory &motor block magnesium sulphate group (group A) showed higher prolongation of sensory & motor block with recovery of pin prick sensation in median time 313 mins ± when compared with group B &C even with longer time taken for patient to request rescue analgesia after 5 hours. In group (B) by adding dexamethasone with bupivacaine the blood pressure rate are increased after 20 min of injection and return normal after 240 min, heart rate are normal, but in case of sensory and motor block about 77.5% of study patient in this group have full motor and sensory block, in case of increasing time of motor and sensory block the dexamethasone success increasing time for motor and sensory block to reach 278 min sensory and 314 min in motor block, first call of Analgesic are after 4 hr. Conclusion: Group A (Magnesium sulphate with bupivacaine) were more effective and increasing affected time in motor and sensory block than Group B (Dexamethasone with Bupivacaine) and Group C (Control).

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COMPARISON OF INTRATHECAL DEXMEDETOMIDINE AND MAGNESIUM SULPHATE AS AN ADJUVANT TO 0.5% HYPERBARIC BUPIVACAINE IN LOWER LIMB SURGERY

10.36106/ijar/8301507 ◽

2021 ◽

pp. 1-3

Author(s):

Shaheer Ahmed Siddiqui ◽

Kapil Rastogi ◽

Aamir Laique Khan

Keyword(s):

Magnesium Sulfate ◽

Postoperative Analgesia ◽

Lower Limb ◽

Motor Block ◽

Onset Time ◽

Sensory Block ◽

Hyperbaric Bupivacaine ◽

Block Level ◽

Lower Limb Surgery ◽

Group B

Background: Epidural anesthesia is commonly used for perioperative as well as postoperative analgesia in lower limb surgeries. Adjuvant in spinal anesthesia prolongs the duration of anesthesia as well as postoperative analgesia. In this study we evaluate the effects of intrathecal dexmedetomidine and magnesium sulfate as an adjuvant to 0.5% hyperbaric bupivacaine in lower limb surgeries. Methods: Total 60 patients belonging to ASA I or II aged 24 to 57 years of either sex were included in this study and randomly distributed into two groups. Group (B+M) received intrathecal 100mg magnesium sulfate and Group (B+D) received intrathecal 5.0 mcg dexmedetomidine with hyperbaric bupivacaine 15mg (3ml of 0.5%). Onset and duration of sensory and motor block, duration of analgesia, hemodynamic changes and complications were recorded. Results: The mean Onset time of sensory block at T10 (min.), Time to maximum sensory block level (min.), Time in minutes for complete motor block (min.), Time for Motor Emergence from Bromage 3 (min.), Time for Sensory Emergence and Time for first analgesia (min) were significantly different between groups. Conclusion: The dexmedetomidine as an adjuvant with hyperbaric bupivacaine leads to earlier onset and prolonged duration of both sensory and motor block as compared to magnesium sulfate.

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A comparative study between the effect of verapamil versus nalbuphine as an adjuvant in supraclavicular brachial plexus block

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-021-00149-3 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Mohammed Ibrahim Khamis ◽

Ahmed Saeed Mohamed ◽

Hesham Mohamed El Azazy ◽

Hala Salah El Ozairy ◽

Mohamed Moien Mohamed

Keyword(s):

Comparative Study ◽

Brachial Plexus ◽

Normal Saline ◽

Motor Block ◽

Brachial Plexus Block ◽

Sensory Block ◽

Motor Blockade ◽

Group A ◽

Group B ◽

Plexus Block

Abstract Background Brachial plexus block has substituted general anesthesia in the majority of patients planned for upper limb surgeries as it avoids the undesired effects of the medications used in general anesthesia as well as the stress response associated with airway manipulation. Opioid agonist–antagonists such as nalbuphine are used as adjuvant to improve the anesthetic properties of bupivacaine. Verapamil has an additive effect in brachial plexus blockade in the form of decreasing the consumption of analgesics in the postoperative period with reducing onset time and extending the duration of motor and sensory blockade. The aim of this study is to investigate the adjuvant effect of verapamil versus nalbuphine to 0.5% bupivacaine in brachial plexus block as regards onset, duration of sensory and motor blockade and postoperative analgesic augmentation. The study is randomized, prospective, double-blinded, comparative study where 90 patients subjected to arm, forearm and hand surgeries were randomized into three groups, group A received 30 ml of plain bupivacaine 0.5% plus 2 ml of normal saline, group B received 30 ml of bupivacaine 0.5% plus 2 ml verapamil equivalent to 5 mg, group C received 30 ml of bupivacaine 0.5% plus 10 mg of nalbuphine diluted in 2 ml of normal saline. Results Results of this study showed that group C and group B sensory block time onset was 7.25 ± 1.5 vs. 10.92 ± 3.84 min, P < 0.001 and was shorter than that in group A (13.2 ± 2.66 min). In addition, the motor block onset was (11.10 ± 1.24 vs. 13.50 ± 3.77 min, P < 0.001) shorter than group A (17.16 ± 1.30 min). In group C and group B, sensory block duration was 396 ± 32.17 vs. 355.83 ± 18.48 min, P < 0.001, respectively and was longer than that in group A (321.13 ± 25.08 min). Also, there was prolonged motor block duration in group C and group B recording (338.92 ± 25.2 vs. 302.93 ± 15.24 min, P < 0.001) and was longer than that in group A (280.70 ± 32.35 min). Time of demand of rescue analgesia dose was significantly long in group C and group B (449.53 ± 52.45 vs. 418.13 ± 41.12 min, P < 0.001) and was longer than group A (361.31 ± 21.42 min). Both verapamil and nalbuphine have additive effect to bupivacaine improving the all anesthetic parameters of the block. Conclusion Both drugs produce favorable enhancement of time onset and effective prolongation of duration of sensory and motor blockade and extend the period of postoperative analgesia with superiority to nalbuphine over verapamil.

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Comparison of Intrathecal Fentanyl and Butorphanol as an Adjuvant to Intrathecal Bupivacaine 0.5% in Infraumbilical Surgeries- A Randomised Double Blind Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44242.13949 ◽

2020 ◽

Author(s):

Sandip Roy Basunia ◽

Prosenjit Mukherjee ◽

Md Bakir Hossain Munshi

Keyword(s):

Spinal Anaesthesia ◽

Motor Block ◽

Controlled Trial ◽

Sensory Block ◽

P Value ◽

Double Blind Study ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Group A ◽

Group B

Introduction: Neuraxial opioids are widely used as adjuvants to local anaesthetic as they improve quality and duration of block. Neuraxial opioids like Butorphanol and Fentanyl allow prolonged analgesia in the postoperative period and faster recovery from spinal anaesthesia. Aim: To compare the safety and efficacy of Butorphanol and Fentanyl combined with bupivacaine for spinal anaesthesia in infraumbilical surgeries. Materials and Methods: The present study was a randomised controlled trial in which 110, ASA I and II patients of either sex who underwent elective infraumbilical surgeries under spinal anaesthesia were selected. Patients were allocated randomly into two groups A (n=55) and B (n=55). Group A (F) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with fentanyl 25 microgram (0.5 mL) to make it total 3.5 mL. Group B (B) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with butorphanol 250 microgram (0.25 mL) and Normal Saline (NS) 0.25 mL to make it total 3.5 mL. Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP), two segment regression time of sensory block, motor block were assessed at preset intervals. Chi-square test or Fischer’s-exact test were used and a p-value ≤0.05 was considered as statistically significant. Results: Mean of two segment sensory regression time of Group A was 41.94±1.73 minutes and Group B was 50.56±4.43 minutes (p<0.0001). Time to onset of motor block in Group A was 5.28±.32 minutes and Group B was 5.27±.32 minutes (p=0.96). Mean duration of motor block in Group A was 81.23±4.87 minutes and Group B was 109.83±2.61 minutes (p<0.0001). Time to rescue analgesic was 289.27±7.37 minutes in Group A and 378.41±10.25 minutes in Group B (p<0.0001). HR, SBP and DBP were comparable among the groups. Conclusion: Intrathecal bupivacaine-butorphanol mixture was clinically better as it provided longer duration of analgesia with lesser incidences of pruritus and nausea/vomiting compared to intrathecal fentanyl-bupivacaine mixture.

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A COMPARATIVE STUDY OF CLONIDINE VERSUS NALBUPHINE AS INTRATHECAL ADJUVANTS TO 0.5% HYPERBARIC BUPIVACAINE DURING LOWER ABDOMINAL SURGERIES – A RANDOMIZED DOUBLE BLIND INTERVENTIONAL STUDY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i3.1004 ◽

2020 ◽

Vol 4 (3) ◽

Author(s):

Trishala Jain ◽

Jaipal .

Keyword(s):

Motor Block ◽

Sensory Block ◽

Double Blind Study ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Rescue Analgesia ◽

Institutional Ethics ◽

Group A ◽

Group B ◽

Intrathecal Clonidine

Background: Regional anesthesia techniques for gynecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for Lower abdominal surgeries in Gynecology. Methods: With institutional ethics committee clearance No. 193MC/EC/2018, randomized, double blind study was conducted. After obtaining informed written consent total of 84 patients scheduled for lower abdominal surgeries were randomly allocated into two groups: Group A (n=42) - Inj. 3.5 ml Bupivacaine 0.5% + 0.2 ml Clonidine(30µg) intrathecally. Group B (n=42) - Inj.3.5 ml Bupivacaine 0.5%+0.2 ml Nalbuphine(2mg) intrathecally. The characteristics of sensory and motor block, hemodynamic data, side effects were recorded. Results: The onset of sensory block was earlier in Group B than Group A (3.08±0.52 min vs 4.00±0.54 min, p<0.001 ). The onset of motor block was also earlier in Group B than Group A (7.78±0.80 min vs 8.80±0.95min, p<0.001). The time to first rescue analgesia in patients receiving intrathecal clonidine was significantly delayed than patients receiving intrathecal nalbuphine (284.95 ± 12.93 min vs 211.52 ± 15.92 min, p<0.001). Introperative hemodynamic changes were comparable and none of the patient suffered from respiratory depression except very little cases of shivering which are not significant. Conclusions: Intrathecal clonidine as adjuvant to bupivacaine provided was clinically more effective than nalbuphine for prolonging the duration of analgesia for gynecological procedures. Keywords: Bupivacaine, Clonidine, Lower abdominal surgeries in gynecology, Nalbuphine, Subarachnoid block.

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A randomised prospective comparative study of evaluation of dexmedetomidine an adjuvant to ropivacaine for ultrasound guided supraclavicular block

International Journal of Clinical Trials ◽

10.18203/2349-3259.ijct20182060 ◽

2018 ◽

Vol 5 (3) ◽

pp. 127

Author(s):

V. S. S. N. Murthy ◽

N. Hari Kiran Verma ◽

Anand Acharya

Keyword(s):

Motor Block ◽

Sensory Block ◽

Study Patient ◽

P Value ◽

Ultrasound Guided ◽

Group A ◽

Prospective Comparative Study ◽

Group B ◽

Supraclavicular Block ◽

Other Regarding

Background: There are clinical evidences for efficacy of dexmedetomidine as an adjuvant to local anaesthetic for peripheral nerve block, but very few published study are available on continuation of dexmedetomidine, with ropivacaine for ultrasound guided supraclavicular block. The present study has been designed to elucidate the effect of dexmedetomidine, in combination ropivacaine on various parameters.Methods: During period of 2 year and 3 months 84 patients were enrolled for this study. Patient in Group A were received 15 ml of 0.5% ropivacaine with 100 microgram one ml dexmedetomidine and Group B were received 15ml of 0.5% of ropivacaine with 1 ml of normal saline. Drug solution was prepared by same individual and was not part of study.Results: Both the group were comparable to each other regarding demography profile. The duration of sensory block 644.96±72.4 min in group A and the duration of sensory block in Group B was 731.53±131.54 min with p value 0.00354. The duration of motor block was 661.5±29.25 in group A and 559.77±29.25 in Group B with P value 0.0001. Duration of analgesia in Group A was 457.06±34.47 min and it was 345.70±38.032 min in Group B. The supplementation of intravenous opioid was required in 3 patients in Group A and 10 patients in group B with P value 0.037.Conclusions: When 100 microgram of dexmedetomidine was added as an adjuvant to ropivacaine is associated with early onset of sensory and motor block, prolongation of sensory and motor block and duration of analgesia in comparison with ropivacaine alone.

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Comparison between isobaric levobupivacaine 0.5% and hyperbaric bupivacaine 0.5% in spinal anesthesia in lower limb surgeries and lower abdominal surgeries in adult patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20210417 ◽

2021 ◽

Vol 9 (2) ◽

pp. 418

Author(s):

Preeti Parashar ◽

Anisha Singh ◽

Manoj Kumar Sharma ◽

Dipak L. Raval

Keyword(s):

Blood Pressure ◽

Lower Limb ◽

Motor Block ◽

Total Duration ◽

Sensory Block ◽

Hyperbaric Bupivacaine ◽

Significant Difference ◽

The Mean ◽

Group B ◽

Mean Time

Background: The aim of our study was to compare sensory and motor block characteristics and hemodynamic changes following intrathecal hyperbaric bupivacaine (0.5%) and isobaric levobupivacaine (0.5%) in elective lower limb and lower abdominal surgeries.Methods: 60 patients of either sex, aged 18-60 years, ASA grade I or II scheduled for elective lower abdominal and lower limb surgeries were randomized into two groups, group B (n=30) and group L (n=30) and received either 3 ml of intrathecal hyperbaric bupivacaine or isobaric levobupivacaine intrathecally.Results: The mean time of onset of sensory block at shin of tibia in both the groups was comparable i.e. levobupivacaine (1.19±0.2 minutes) and bupivacaine (1.1+0.2 minutes). The mean time for total duration of sensory block was 211.1±8.2 minutes in group L, while 193.13±13.7 minutes in group B. Time for total duration of motor block in group L was 198.76±8.428 minutes and in group B was 182.6±13.989 minutes. Statistically significant difference was observed in total duration of sensory and motor block in both levobupivaciane and bupivacaine group (p<0.0001). Patients in group L were hemodynamically more stable with significantly less decrease in pulse rate, systolic blood pressure and diastolic blood pressure as compared to group B.Conclusions: We observed that 0.5% isobaric levobupivacaine provided better hemodynamic stability, longer duration of sensory and motor block as compared to bupivacaine.

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A COMPARISON BETWEEN INTRATHECAL NALBUPHINE VERSUS FENTANYL AS AN ADJUVANT WITH 0.5% HYPERBARIC BUPIVACAINE FOR POSTOPERATIVE ANALGESIA IN PATIENTS UNDERGOING LOWER SEGMENT CESAREAN SECTION

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i8.2081 ◽

2021 ◽

Vol 5 (8) ◽

Author(s):

Mukesh Choudhary ◽

Neeti Mahla

Keyword(s):

Cesarean Section ◽

Postoperative Analgesia ◽

Motor Block ◽

Sensory Block ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Lower Segment Cesarean Section ◽

Group A ◽

The Mean ◽

Group B

Background: Subarachnoid block is the preferred anesthesia for cesarean section, being simple to perform and economical with rapid onset. This study aims to compare the postoperative analgesia of intrathecal nalbuphine and fentanyl as adjuvants to bupivacaine in cesarean section. Methods: A prospective, randomized, double?blind, and comparative study was conducted on 120 patients of American Society of Anesthesiologists (ASA) physical status I and II. These patients were randomized into three groups with fifty patients in each group. Group A received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml nalbuphine (0.8 mg), Group B received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml fentanyl (20 ?g), and Group B received 2 ml of 0.5% hyperbaric bupivacaine (10 mg) plus 0.4 ml of normal saline. Results: The mean duration of sensory block was 107.32 ± 5.36 min in Group A, 111.23 ± 4.23 min in Group B, and 85.69 ± 2.31 min in Group C. The mean duration of motor block (time required for motor block to return to Bromage’s Grade 1 from the time of onset of motor block) was 152.02 ± 3.12 min in Group A, 151.69± 2.36 min in Group B, and 122.12 ± 2.32 min in Group C. Conclusion: We concluded that intrathecal nalbuphine prolongs postoperative analgesia maximally and may be used as an alternative to intrathecal fentanyl in cesarean section. Keywords: Nalbuphine, Bupivacaine, Fentanyl.

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COMPARISON OF THE ONSET OF SENSORY BLOCK USING LIDOCAINE 1.5% WITH ADRENALINE OR LIDOCAINE 1.5% WITH ADRENALINE AND DEXAMETHASONE IN ULTRASOUND GUIDED AXILLARY NERVE BLOCK FOR BELOW ELBOW SURGERIES

Wiadomości Lekarskie ◽

10.36740/wlek202109214 ◽

2021 ◽

Vol 74 (9) ◽

pp. 2337-2339

Author(s):

Nabaa Adnan Ahmed ◽

Alaa Hussein Altaei ◽

Mohammed Adel Jasim

Keyword(s):

Peripheral Nerve ◽

Nerve Block ◽

Peripheral Nerve Block ◽

Onset Time ◽

Sensory Block ◽

Axillary Nerve ◽

P Value ◽

Group A ◽

Group 2 ◽

Group B

The aim: To demonstrate the onset of dexamethasone when added to lidocaine in ultrasound regional axillary brachial block. Materials and methods: 30 patients participated in this study in Al-wasity hospital from June 1st to December 1st 2019; all were of ASA I-II type, aged 18-65 years old. All patients were scheduled for upper limb below elbow surgery with peripheral nerve block. They were divided randomly in to 2 groups: Group A: received 20 ml of lidocaine 1.5% with adrenaline 1:200000; Group 2 : received 20 ml of lidocaine with adrenaline and dexamethasone 8 mg. There was no significant differences among the groups regarding the change in pulse rate, MAP and Oxygen saturation. The group B was faster than group A (p value < 0.001) in both the time of cold sensory block onset and pinprick sensory block onset at all dermatome (C5,C6,C7,C8,T1). Results: A variety of adjuvants have been used with peripheral nerve block to decrease the onset time, improve block quality, and prolong analgesia. Steroids have been shown to be beneficial in improving block onset. Conclusions: Adding dexamethasone to lidocaine enhanced the onset time of the block with no hemodynamic effect.

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