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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
90
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).
Tanta University
Tanta, El-Gharbia, Egypt
Time to the first request of analgesia
Time to the first request of analgesia was recorded from the end of surgery till the first dose of pethidine administrated.
Time frame: 24 hours postoperatively
Degree of pain
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.
Time frame: 24 hours postoperatively
Patient Satisfaction
Postoperative Patient Satisfaction measured in " 4 scale patient satisfaction score" ( 1 = highly satisfied , 2 = fairly satisfied , 3 = little satisfied , 4 = non satisfied ).
Time frame: 24 hours postoperatively
Total Analgesics consumption
Pethidine 50 mg intravenous was given as postoperative rescue analgesia when the Numeric Rating Scale (NRS) score was≥ 4.
Time frame: 24 hours postoperatively
Incidence of complications
Incidence of complications such as nausea, vomiting, hypotension and bradycardia were recorded.
Time frame: 24 hours postoperatively
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