Saikarthik, A J (2017) A Comparative evaluation of efficacy of Bupivacaine 0.25% and Bupivacaine 0.25% with Dexamethasone in Parascalene Block for Upper Limb Surgeries. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: Parascalene block has been proved to be a safe and effective alternative to various approaches in brachial plexus block in terms of safety by avoiding complications like pneumothorax, phrenic nerve paralysis etc. Dexamethasone has been proved as a good additive to local anesthetic in peripheral nerve blocks by shortening the onset of sensory and motor blockade and prolonging duration of analgesia. postoperative pain and discomfort was also shown to be reduced. OBJECTIVES: This study was done to compare the efficacy of Bupivacaine 0.25% and Bupivacaine 0.25% with dexamethasone in parascalene block for upper limb surgeries. MATERIALS AND METHODS: Patients undergoing upper limb surgeries of ASA 1 and ASA 2 (n=30) undergoing Parascalene block by 22G Nerve locator were randomly allocated into two groups of Group B who receives 30 ml of Bupivacaine 0.25% and Group BD who receives 28 ml of Bupivacaine 0.25% with 8 mg of dexamethasone. The duration of analgesia is compared as the primary outcome. other parameters like Time of onset of sensory and motor blockade, time of first rescue analgesia,Post operative VAS scores, perioperative and postoperative Hemodynamic parameters were compared as the secondary outcome. All groups were assessed for complications. RESULTS: The mean duration of analgesia is significantly prolonged in Group BD with mean time of 595.43 min compared to Group B where it was 311.40 min. The mean onset of sensory block was significantly shortened in Group BD with mean onset time of 4.67 min compared to Group B where it was 7.67 min. The mean onset time of motor block was significantly shortened in Group BD with 2.80 min compared to Group B where it was 3.50 min. The mean time of first rescue analgesia was significantly delayed in Group BD where it was 600.13 min compared to Group B where it was 319.06 min. The post operative VAS score was significantly lesser in Group BD where it was 3.55 compared to Group B where it was 4.09. Heart rate was significantly reduced in Group BD and Mean arterial pressure was significantly raised in Group BD. CONCLUSION: In conclusion,addition of 8 mg of Dexamethasone to 0.25% Bupivacaine 28 ml for parascalene block,quickens the onset of Sensory and motor blockade and prolongs the duration of Analgesia. It also improves the quality of post operative analgesia. It also decreases heart rate and increases the mean arterial pressure without causing hemodynamic instability. It also reduces post operative nausea and vomiting. Hence Dexamethasone can be considered a safe additive to local anesthetic in brachial plexus block.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.201520003 |
| Uncontrolled Keywords: | Parascalene Block, Bupivacaine 0.25%, Dexamethasone 8mg, Duration of Analgesia. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Subramani R |
| Date Deposited: | 21 Jul 2020 03:13 |
| Last Modified: | 21 Jul 2020 03:13 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12606 |
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