Comparing the effect of adding 8mg Dexamethasone to 0.25% bupivacaine to plain bupivacaine 0.25% in Erector spinae plain block in Modified radical mastectomy patients: A Randomized Controlled Study.
Guleria, J., Sood, A., Chaudhary, U. (2024). Comparing the effect of adding 8mg Dexamethasone to 0.25% bupivacaine to plain bupivacaine 0.25% in Erector spinae plain block in Modified radical mastectomy patients: A Randomized Controlled Study.. EKB Journal Management System, 16(1), 1-6. doi: 10.21608/asja.2024.250823.1017
Jyotsna Guleria; Ajay Sood; Usha K Chaudhary. "Comparing the effect of adding 8mg Dexamethasone to 0.25% bupivacaine to plain bupivacaine 0.25% in Erector spinae plain block in Modified radical mastectomy patients: A Randomized Controlled Study.". EKB Journal Management System, 16, 1, 2024, 1-6. doi: 10.21608/asja.2024.250823.1017
Guleria, J., Sood, A., Chaudhary, U. (2024). 'Comparing the effect of adding 8mg Dexamethasone to 0.25% bupivacaine to plain bupivacaine 0.25% in Erector spinae plain block in Modified radical mastectomy patients: A Randomized Controlled Study.', EKB Journal Management System, 16(1), pp. 1-6. doi: 10.21608/asja.2024.250823.1017
Guleria, J., Sood, A., Chaudhary, U. Comparing the effect of adding 8mg Dexamethasone to 0.25% bupivacaine to plain bupivacaine 0.25% in Erector spinae plain block in Modified radical mastectomy patients: A Randomized Controlled Study.. EKB Journal Management System, 2024; 16(1): 1-6. doi: 10.21608/asja.2024.250823.1017

Comparing the effect of adding 8mg Dexamethasone to 0.25% bupivacaine to plain bupivacaine 0.25% in Erector spinae plain block in Modified radical mastectomy patients: A Randomized Controlled Study.

Ain-Shams Journal of Anesthesiology
Volume 16, Issue 1, 2024, Pages 1-6    PDF (404.11 K)
Document Type: Original Article
DOI: 10.21608/asja.2024.250823.1017
Authors
Jyotsna Guleria1; Ajay Sood2; Usha K Chaudhary* 3
1IGMC,Shimla, HP.India
2Department of Anaesthesia, IGMC,Shimla, Himachal Pradesh, India
3Department of Anaesthesia, IGMC, Shimla,HP,India
Abstract
Background: Ultrasound guided (USG guided) Erector spinae plane block is a simple, safe regional block being used for carcinoma breast patients posted for Modified Radical Mastectomy(MRM). Nowadays, many adjuvants are added to local anaesthetics to increase the duration of analgesia and make them more effective. As there were no studies on effect of adding dexamethasone as an adjuvant to bupivacaine in erector spinae block in MRM patients, a double blind, randomised controlled study was done in carcinoma breast patients.

Purpose of study was to determine the pain free duration postoperatively. secondary outcome was to study total rescue analgesia requirement in 24 hours, Patient satisfaction score and any other side effects like postoperative nausea and vomiting, bradycardia etc. Seventy ASA 1&2 females , diagnosed with carcinoma Breast and posted for elective MRM surgery in age group of 18-65 years were enrolled.Group 1 patients received Ultrasound guided Erector spinae plane block with 20ml Bupivacaine 0.25% plain and Group 2 patients received 20 ml of Bupivacaine 0.25% with 8mg of injection Dexamethasone.



Results: Group 2 had longer pain free duration (17 ± 6.18 hours) compared to Group 1 (6.97 ± 4.01 hours) (p value=0.0001). In Group 2: Tramadol consumption as rescue analgesia was lesser, lower incidence of Postoperative nausea and vomiting, better patient satisfaction score compared to Group 1. Haemodynamic stability was comparable in both groups.

Conclusions: Adding dexamethasone to local anaesthetics decreases consumption of rescue analgesia or opioids and increases the duration of analgesic effect of ESP block.
Keywords
Erector spinae plane(ESP) block; Modified Radical Mastectomy (MRM); dexamethasone
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