Intravenous versus Perineural Dexamethasone in Interscalene Nerve Block with Levobupivacaine for Shoulder and Upper Arm Surgeries
weheba, H., El-Ebahnsawy, N., Badr-Eldin, M., El-Badrawy, R. (2022). Intravenous versus Perineural Dexamethasone in Interscalene Nerve Block with Levobupivacaine for Shoulder and Upper Arm Surgeries. EKB Journal Management System, 86(1), 882-890. doi: 10.21608/ejhm.2022.218047
hazem moawad weheba; Nahla Salama El-Ebahnsawy; Mahmoud Nabil Badr-Eldin; Rania El-Mohamady El-Badrawy. "Intravenous versus Perineural Dexamethasone in Interscalene Nerve Block with Levobupivacaine for Shoulder and Upper Arm Surgeries". EKB Journal Management System, 86, 1, 2022, 882-890. doi: 10.21608/ejhm.2022.218047
weheba, H., El-Ebahnsawy, N., Badr-Eldin, M., El-Badrawy, R. (2022). 'Intravenous versus Perineural Dexamethasone in Interscalene Nerve Block with Levobupivacaine for Shoulder and Upper Arm Surgeries', EKB Journal Management System, 86(1), pp. 882-890. doi: 10.21608/ejhm.2022.218047
weheba, H., El-Ebahnsawy, N., Badr-Eldin, M., El-Badrawy, R. Intravenous versus Perineural Dexamethasone in Interscalene Nerve Block with Levobupivacaine for Shoulder and Upper Arm Surgeries. EKB Journal Management System, 2022; 86(1): 882-890. doi: 10.21608/ejhm.2022.218047

Intravenous versus Perineural Dexamethasone in Interscalene Nerve Block with Levobupivacaine for Shoulder and Upper Arm Surgeries

The Egyptian Journal of Hospital Medicine
Article 145, Volume 86, Issue 1, January 2022, Page 882-890  XML PDF (588.63 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2022.218047
View on SCiNiTO View on SCiNiTO
Authors
hazem moawad weheba email orcid ; Nahla Salama El-Ebahnsawy; Mahmoud Nabil Badr-Eldin; Rania El-Mohamady El-Badrawy
department of anesthesia, faculty of medicine, Mansoura university, Egypt
Abstract
Background: Interscalene brachial plexus block (IBPB) has gained importance for surgical purposes and pain management. It provides effective postoperative pain relief essential for patient comfort andearly ambulation.
Objective: To evaluate the effect of dexamethasone as adjuvant to levobupivacaine in ultrasound-guided IBPB in shoulder and upper arm surgeries, and which route, the perineural or the intravenous was more effective.
Patients and methods: Ninety patients randomly allocated into 3 equal groups: Group L: received IBPB with 20 ml of 0.5% levobupivacaine plus 2 ml normal saline (NS) with intravenous (iv) 10 ml NS. Group LDP: received IBPB with 20 ml of 0.5% levobupivacaine plus dexamethasone 4 mg diluted in 2 ml NS with iv 10 ml NS. Group LDIV: received IBPB with 20 ml of 0.5% levobupivacaine plus 2 ml NS with iv dexamethasone 4 mg diluted in 10 ml NS.
Results: Patients in group LDP took prolonged time to ask for the first request for analgesia compared with patients in group L and group LDIV (15.57±3.89 vs 13.23±2.65 and 13.57±3.22, respectively) (p=0.007 and p=0.02, respectively), but no significant difference between group L and group LDIV (p=0.696). Pethidine consumption was significantly increased in patients of group L compared with patients in group LDP and group LDIV (p < 0.001 and p < 0.001, respectively), but no significant difference in pethidine dose between group LDP and group LDIV (p=0.283).
Conclusion: This study concluded that the addition of dexamethasone as an adjuvant to perineural levobupivacaine for IBPB prolonged the duration of analgesia, decreased the postoperative pain score, decreased pethidine consumption and improved patient satisfaction.
 
Keywords
Dexamethasone; Interscalene block; Levobupivacaine; Upper arm Surgeries
Statistics
Article View: 226
PDF Download: 331