Publication: Effectiveness of addition of neostigmine or dexamethasone to local anaesthetic in providing perioperative analgesia for brachial plexus block: A prospective, randomized, double blinded, controlled study
Date
2008
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Background: Various local anaesthetic agents are used for brachial plexus block.We compared effectiveness of addition
of Dexamethasone versus Neostigmine to Lignocaine, adrenaline admixtures for Brachial plexus block in providing
perioperative analgesia.
Methods: Ninety patients were randomized in three groups and were received 24ml of study drugs. The groupA
[Lignocaine with adrenaline (1.5%)], groupB [Lignocaine with adrenaline (1.5%)] +500μg Neostigmine, and group C
(Lignocaine with adrenaline (1.5%) +4mg Dexamethasone) for brachial plexus block through supraclavicular approach.
The observed parameters were onset of analgesia, completion of sensory and motor blockade, Duration of analgesia,
Surgeon’s score, side effects, number of supplemental analgesics doses and Visual analogue scale (VAS) score for pain
in 12 hour of post-operative period.
Results: Mean onset of analgesia 4.6±1.1 , 4.4 ±0.8 , 3.8±1.8 mins in group A,B and C respectively and the Mean onset
of motor blockade were 7.7± 2.0, 7.0±1.8, 6.0 ± 2.1mins in group A,B and C respectively. Similarly Mean Complete
sensory block in 10.6 ±3, 10.4±2.5, and 8.9±2.2mins and Mean complete motor block in 17.3±4.3, 17.2 ±4.0 and
14.7±3.5 mins in group A, B and C respectively were achieved. Duration of analgesia was 176.5±53.5, 225.7±53.3 and
454.2±110.7 mins in group A, B and C respectively. Duration of analgesia in group C was statistically signi cant in
comparison with other groups. The number of mean analgesic requirement by group C (0.9±0.4) was signi cantly (p-
0.005) lower. The mean VAS was signi cantly lower in groupC in 12 hours post-operatively.
Conclusion: The onsets of action, duration of analgesia were better in dexamethasone group and also need less number
of rescue analgesics requirement.
Description
Yadav RK 1, Sah BP 2, Kumar P3, Singh SN 4
1Postgraduate Student, 2 Associate Professor, 4Assistant Professor, Department of Anaesthesiology and Critical care,3Assistant Professor, Department of Orthopaedics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal